Enfestasyonlar ve Karın Ağrısı: Parazitozlar
Özet
Bu bölümde karın ağrısı ile acil servise başvuran hastalarda önemli ancak sıklıkla gözden kaçabilen bir neden olan paraziter enfeksiyonlar ele alınmıştır. Protozoonlar (Giardia, Entamoeba vb.) genellikle ishal ve inflamatuar ağrıya yol açarken, helmintler (Ascaris, kistik ekinokokkoz, Fasciola vb.) mekanik obstrüksiyon, biliyer kolik ve cerrahi aciller gibi ciddi tablolarla ilişkilidir. Tanıda epidemiyolojik öykü, eozinofili ve görüntüleme yöntemleri kritiktir. Tedavi, etkene yönelik antiparaziter ajanların yanı sıra, dehidratasyon, anemi ve obstrüksiyon gibi komplikasyonların yönetimini de içermelidir. Acil serviste, özellikle Strongyloides hiperenfeksiyonu, kist hidatik rüptürü ve nörosistiserkoz gibi yaşamı tehdit eden durumların farkında olunmalıdır.
Parasitic infections, an important yet often overlooked cause in patients presenting to the emergency department with abdominal pain, have been addressed. Protozoa (Giardia, Entamoeba, etc.) typically lead to diarrhea and inflammatory pain, while helminths (Ascaris, hydatid cyst, Fasciola, etc.) are associated with serious conditions such as mechanical obstruction, biliary colic, and surgical emergencies. Epidemiological history, eosinophilia, and imaging methods are critical in diagnosis. Treatment should include both specific antiparasitic agents for the causative organism and management of complications such as dehydration, anemia, and obstruction. In the emergency department, particular awareness should be maintained for life-threatening conditions like Strongyloides hyperinfection, hydatid cyst rupture, and neurocysticercosis.
Referanslar
World Health Organization. Soil-transmitted helminth infections. (25.12.2025 tarihinde https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections adresinden ulaşılmıştır).
Tembo SJ, Mutengo MM, Sitali L, et al. Prevalence and genotypic characterization of Giardia duodenalis isolates from asymptomatic school-going children in Lusaka, Zambia. Food and Waterborne Parasitology. 2020;19:e00072. doi:10.1016/j.fawpar.2020.e00072
Miko S, Kache PA, Imada E, et al. Postinfectious syndromes and long-term sequelae after Giardia infections. Emerging Infectious Diseases. 2025;31(14):45–52. doi:10.3201/eid3114.241793
Chou A, Austin RL. Entamoeba histolytica infection. 2023 Apr 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32491650.
Rostami A, Riahi SM, Haghighi A, et al. The role of Blastocystis sp. and Dientamoeba fragilis in irritable bowel syndrome: a systematic review and meta-analysis. Parasitology Research. 2017;116(9):2361–2371. doi:10.1007/s00436-017-5535-6
Checkley W, White AC Jr, Jaganath D, et al. A review of the global burden, novel diagnostics, therapeutics, and vaccine targets for cryptosporidium. The Lancet Infectious Diseases. 2015;15(1):85–94. doi:10.1016/S1473-3099(14)70772-8
Kalita JM, Ravi P, Tak V, et al. Concurrent Cryptosporidium and Cystoisospora infection in a patient with HIV infection. Tropical Parasitology. 2025;15(2):128–131. doi:10.4103/tp.tp_15_25
Almeria S, Chacin-Bonilla L, Maloney JG, et al. Cyclospora cayetanensis: a perspective (2020–2023) with emphasis on epidemiology and detection methods. Microorganisms. 2023;11(9):2171. doi:10.3390/microorganisms11092171
Lynser D, Handique A, Daniala C, et al. Sonographic images of hepato-pancreatico-biliary and intestinal ascariasis: a pictorial review. Insights into Imaging. 2015;6(6):641–646. doi:10.1007/s13244-015-0428-7
Fatemiyoun SA, Rafiei F, Sheikhalishahi SSA. Acute abdomen due to small bowel obstruction by Ascaris lumbricoides in an 18-year-old male: a case report and review of the literature. Clinical Case Reports. 2025;13(5):e70524. doi:10.1002/ccr3.70524
García HH, Gonzalez AE, Evans CA, et al. Taenia solium cysticercosis. The Lancet. 2003;362(9383):547–556. doi:10.1016/S0140-6736(03)14117-7
Referanslar
World Health Organization. Soil-transmitted helminth infections. (25.12.2025 tarihinde https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections adresinden ulaşılmıştır).
Tembo SJ, Mutengo MM, Sitali L, et al. Prevalence and genotypic characterization of Giardia duodenalis isolates from asymptomatic school-going children in Lusaka, Zambia. Food and Waterborne Parasitology. 2020;19:e00072. doi:10.1016/j.fawpar.2020.e00072
Miko S, Kache PA, Imada E, et al. Postinfectious syndromes and long-term sequelae after Giardia infections. Emerging Infectious Diseases. 2025;31(14):45–52. doi:10.3201/eid3114.241793
Chou A, Austin RL. Entamoeba histolytica infection. 2023 Apr 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32491650.
Rostami A, Riahi SM, Haghighi A, et al. The role of Blastocystis sp. and Dientamoeba fragilis in irritable bowel syndrome: a systematic review and meta-analysis. Parasitology Research. 2017;116(9):2361–2371. doi:10.1007/s00436-017-5535-6
Checkley W, White AC Jr, Jaganath D, et al. A review of the global burden, novel diagnostics, therapeutics, and vaccine targets for cryptosporidium. The Lancet Infectious Diseases. 2015;15(1):85–94. doi:10.1016/S1473-3099(14)70772-8
Kalita JM, Ravi P, Tak V, et al. Concurrent Cryptosporidium and Cystoisospora infection in a patient with HIV infection. Tropical Parasitology. 2025;15(2):128–131. doi:10.4103/tp.tp_15_25
Almeria S, Chacin-Bonilla L, Maloney JG, et al. Cyclospora cayetanensis: a perspective (2020–2023) with emphasis on epidemiology and detection methods. Microorganisms. 2023;11(9):2171. doi:10.3390/microorganisms11092171
Lynser D, Handique A, Daniala C, et al. Sonographic images of hepato-pancreatico-biliary and intestinal ascariasis: a pictorial review. Insights into Imaging. 2015;6(6):641–646. doi:10.1007/s13244-015-0428-7
Fatemiyoun SA, Rafiei F, Sheikhalishahi SSA. Acute abdomen due to small bowel obstruction by Ascaris lumbricoides in an 18-year-old male: a case report and review of the literature. Clinical Case Reports. 2025;13(5):e70524. doi:10.1002/ccr3.70524
García HH, Gonzalez AE, Evans CA, et al. Taenia solium cysticercosis. The Lancet. 2003;362(9383):547–556. doi:10.1016/S0140-6736(03)14117-7
