toxocara.doc siver.doc

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UNIVERSIDAD CATLICANUESTRA SEORA DE LA ASUNCIN

SEDE REGIONAL GUAIRA

FACULTAD DE MEDICINA

DEPARTAMENTO DE DOCENCIA E INVESTIGACINDEPARTAMENTO DE PEDIATRA

HOSPITAL NACIONAL DE ITAUGUA

TOXOCARA CANIS EN POBLACIN PEDITRICARURAL

Monografa para acc!r a" T#$"o !E%pc&a"&%#a n P!&a#ra

Dra' S&"(&a Mar&%o" R&(ro% M$)o*

ITAUGUA GUAZU- PARAGUAYAo 2009


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MESA EXAMINADORA

Monografa !" #"$%$ a&ro'a!a "n no('r" !" )a*

Un&(r%&!a! Ca#+"&ca N$%#ra S)ora ! "a A%$nc&+nS! Rg&ona" G$a&ra,Fac$"#a! ! M!&c&na - !"Dpar#a.n#o ! Docnc&a In(%#&gac&+n - "Dpar#a.n#o ! P!&a#ra /o%pa" Nac&ona" ! I#a$g$a

M%a 0a.&na!oraNo.1r - ap""&!o F&r.a - %""o

L%'ro !" a+#a* N,("ro Pg%na Ao

."+/a* .%r(a $"))o a1#or%a!o$


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2NDICE

TA3LA DE CONTENIDO P4GINA

3USTI.ICACI4N

RESUMEN

CAPTULO I

INTRODUCCI4N 5MARCO TE4RICO 6

CAPTULO II

O73ETI8OS 6

MATERIAL Y M:TODOS 6;

CAPTULO IIIRESULTADOS J $%"n!o +on$%!"ra!o +o(o ") &r%n+%&a) ag"n#" +a1$a) !" )a

To@o+ar%a$%$ /1(ana (30, 32,33)

Son g1$ano$+%)n!r%+o$ !" "@#r"(o$ &1n#%ag1!o$ +on 6 )a'%o$ "n $1 'o+a !"

+o)or ro$a!o +)aro-na+ara!o Lo$ a!1)#o$ H"('ra .%g


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En )o$ &"rro$ ") +%+)o '%o)?g%+o "$ +o(&)"o &or )a !%F"r$%!a! !" (a% !

#ran%.&%&+n9 >F&g' ? - @

Tran%.&%&+n !&rc#a9

-Por )a %ng"$#a !" /1"Fo$ !"&o$%#a!o$ "n ") $1")o

-Por %ng"$#a !" /o$&"!a!or"$ &ara#n%+o$ +o(o +1+ara+/a$ )o('r%+"$

ro"!or"$ T"n"'r%1$ $&

Tran%.&%&+n &n!&rc#a9

,Por &a$a" !" )arFa$ !"$!" ") #"%!o (1$+1)ar a) %n#"$#%no !")ga!o #ran$(%$%?n

&r"na#a) o #ran$-1#"r%naJ

-Por &a$a" !" )arFa$ a #raF$ !") +a)o$#ro Fa )a+#ogn%+aJ

Lo$ &"rro$ +on &ar$%#o$ a!1)#o$ "n ") %n#"$#%no ")%(%nan )o$ /1"Fo$ 1n#o +on

)a$ /"+"$ !" "$#a (an"ra &roFo+an )a +on#a(%na+%?n '%o)?g%+a !") ("!%o

a('%"n#"

F&g' ? 8a$ !" +on#ag%o !" Toxocara Canis


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F&g' @ E$B1"(a !") +%+)o !" F%!a !"Toxocara Canis


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8', CICLO VITAL EN ANIMALES

Lo$ &ar$%#o$ a!1)#o$ !" To@o+ara Can%$ #%"n"n r"&ro!1++%?n $"@1a) "n )a B1"

") (a+/o f"+1n!a a )a /"('ra &ara B1" "$#a ("!%an#" /1"Fo$ !%$"(%n" )a

%nf"++%?n a) a('%"n#" 66J


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E) /"+/o !" )a /a'%)%!a! &ara )a #ran$(%$%?n F"r#%+a)* #ran$&)a+"n#ar%a

#ran$(a(ar%a "n )a fa$" +a)o$#ra) +o(o )a$ &r%n+%&a)"$ for(a$ !" +on#ag%o "n

)o$ &"rro$ "$ ") f"n?("no '%o)?g%+o B1" )" &"r(%#" (o$#rar 1na ")"Fa!$%(a

&r"Fa)"n+%a "n )o$ +a+/orro$* 90 - 500 E$#a #"n!"n+%a $" Fa /a+%"n!o ("nor

"n an%(a)"$ a &ar#%r !" )o$ - < ("$"$ !" "!a! !" (an"ra B1" "n )a &o')a+%?n

a!1)#a )a &r"Fa)"n+%a f)1+#,a "n a)r"!"!or !") 5< 69J La +%#a an#"r%or $"

r"f%"r" a "$#1!%o$ r"a)%a!o$ "n Nor#" A(r%+a o#ra$ +%1!a!"$ !") (1n!o B1"

%n+)1"n a)r"!"!or !" 9 000 &"rro$ !on!" /a an#"+"!"n#"$ !"

!"$&ara$%#a+%?n D" )o +%#a!o "$ "F%!"n#" B1" )o$ (aor"$ !%$&"r$or"$

+on#a(%na!or"$ $on )o$ +a+/orro$ 6;69J

AB1 "n ") &a$ /a "$#1!%o$ !" &r"Fa)"n+%a "n $1")o$ B1" r"F")an 1n


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En +1an#o a) +%+)o '%o)?g%+o !") #o@o+ara +an%$ 1na F" B1" )o$ /1"Fo$ )arFa!o$

$on %ng"r%!o$ $" ))"Fa a +a'o "n ") %n#"$#%no !")ga!o )a$ )arFa$ &"n"#ran )a

(1+o$a (%gran a) /ga!o &or )a F"na &or#a &a$an a )o$ &1)(on"$ &or )a

+%r+1)a+%?n $%$#(%+a ))"gan a !%F"r$o$ #"%!o$ &"ro $%n a)+anar n1"Fa("n#" ")

#ra+#o !%g"$#%Fo .%g 55J E) !ao a )o$ #"%!o$ $" !"'" a )a r"a++%?n %nf)a(a#or%a

B1" !"an )a$ )arFa$ a $1 &a$o !" )a %nf"++%?n "n $ 6>J

Lo$ /1"Fo$ %ng"r%!o$ "+)o$%onan )%'"ran!o )a$ )arFa$ "n ") %n#"$#%no B1" ))"gan

&or Fa $ang1n"a a )a$ F$+"ra$ &r%n+%&a)("n#" a) /ga!o !on!" $" &ro!1+"n

gran1)o(a$ "o$%nof)%+o$ D1ran#" )a %nf"++%?n $" &1"!" o'$"rFar

/"&a#o("ga)%a "$&)"no("ga)%a f%"'r" anor"@%a !%arr"a $n#o(a$

&1)(onar"$ 6 > 606>J

A) (%grar )a$ )arFa$ &or #o!o ") organ%$(o &1"!"n "n+on#rar$" +o(o $"

("n+%on? an#"$ "n +1a)B1%"r #"%!o 1 ?rgano /ga!o &1)(on"$ +ora?n

+"r"'roJ E$#a (%gra+%?n )arFa) !"a $1$ $"+1")a$ !" %nf)a(a+%?n /"(orrag%a$

n"+ro$%$ &1"!" &ro!1+%r 1n +1a!ro +)n%+o B1" "n a)g1na$ o&or#1n%!a!"$

&1"!" $"r graF" B1" $" !"no(%na $n!ro(" !" Lar(a M&gran# V&%cra"

0J E$#" $n!ro(" "$ ($ fr"+1"n#" "n n%o$ !" 5 a ao$ a B1"

g"n"ra)("n#" "))o$ #%"n"n (a)o$ /'%#o$ /%g%n%+o$ &"r(an"+"n ($ "n

+on#a+#o +on )o$ &"rro$ +on ") a('%"n#" "n B1" "$#o$ $" !"$"nF1")F"n .%g

55J

A)g1na$ )arFa$ $on !"$#r1%!a$ &or ") $%$#"(a %n(1n" !") /o$&"!"ro &"ro )a

(aora $o)o !"#%"n"n $1 +r"+%(%"n#o (an#"n%n!o$" F%Fa$ ("#a'?)%+a("n#"a+#%Fa$ >5J

A F"+"$ )a$ )arFa$ &1"!"n a)+anar ") $%$#"(a n"rF%o$o &roFo+ar +1a!ro$ !"

"n+"fa)%#%$ o ("n%ng%#%$K "n o#ra$ o&or#1n%!a!"$ &1"!" %r a )o+a)%ar$" a )o$

oo$ &roFo+ar 1na fa))a F%$1a) E$#" +1a!ro $" +ono+" +on ") no('r" !"

To0ocar&a%&% Oc$"ar $" o'$"rFa "n n%o$ (aor"$ !" ao$ a!o)"$+"n#"$

a!1)#o$ 6 ;>J


19/75

A $1 &a$o &or ") #orr"n#" $ang1n"o )a$ )arFa$ !" To@o+ara Can%$ &ro!1+"n

&ro#"na$ g)%+o$%)a!a$ B1" nor(a)("n#" $" +ono+" +o(o an#g"no$ To@o+ara

"@+r"#or-$"+r"#orK "$#o$ an#g"no$ %n!1+"n 1n #%&o T/2-CD (a$ r"$&1"$#a

%n(1n" +")1)ar B1" $" +ara+#"r%a &or )a &ro!1++%?n !" %n#"r)"1+%na B1"

&ro(1"F" ") +a('%o !" %$o#%&o$ !" +)1)a$ 7 a )a &ro!1++%?n !"

%n(1nog)o'1)%na E IgGJ )a %n#"r)"1+%na


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;' MANIFESTACIONES CL2NICAS

La #o@o+ar%a$%$ o gran1)o(a#o$%$ &ara$%#ar%a "$ 1na &ara$%#o$%$ )arFa)

$%$#(%+a B1" $" &r"$"n#a "n for(a a$%n#o(#%+a o +on !%F"r$a$(an%f"$#a+%on"$ !"&"n!%"n!o !") ?rgano af"+#a!o #a)"$ +o(o*

- Co(&ro(%$o r"$&%ra#or%o

- Eo$%nof%)%a

- .%"'r"

- H"&a#o("ga)%a

- E$&)"no("ga)%a

- A!"no&a#a$

- Af"+#a+%?n !") $%$#"(a n"rF%o$o +"n#ra)

- M%o+ar!%o

- P%")

D%+/a$ (an%f"$#a+%on"$ $on ") r"$1)#a!o !" Far%o$ fa+#or"$* )o$ !ao$

("+n%+o$ r"a++%ona)"$ o+a$%ona!o$ &or )a$ )arFa$ (%gran#"$ )o$ ?rgano$

B1" r"$1)#an af"+#a!o$ ") n,("ro !" )arFa$ )a %n#"n$%!a! !" )a r"$&1"$#a

%n(1no)?g%+a &roFo+a!a &or $1 &r"$"n+%a 59 2


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Df%+%# +ogn%#%Fo P"r%+ar!%#%$ +on$#r%+#%FaLarFa (%gran$ +1#n"a D"rra(" &)"1ra)C%$#%+"r+o$%$ N"1(ona.a$+%o)a$%$ In$1f%+%"n+%a r"$&%ra#or%a.%"'r" "n )a+#an#"$ R"#%no')a$#o(a

Sn!ro(" /%&"r"o$%nof)%+o E$#rong%)o%!%a$%$N"1(on%#%$ &or /%&"r$"n$%'%)%!a! E$B1%$#o$o(%a$%$Gna#/o$#o(%a$%$

C)n%+a("n#" $" r"+ono+"n +1a#ro for(a$ !" &r"$"n#a+%?n*

5 LarFa M%gran$ 8%$+"ra) LM8J

2 LarFa MigransO+1)ar LMOJ

6 To@o+ar%a$%$ n"1ro)?g%+a

To@o+ar%a$%$ "n+1'%"r#a

D" )a$ +%#a!a$ no$ r"f"r%r"(o$ +on ($ !"#a))"$ a )a$ !o$ &r%("ra$ a B1"

r"&r"$"n#an "n#%!a!"$ (a$ fr"+1"n#"$ "n ") /o('r"

;'6' LARVA MIGRANS VISCERAL >LMV

E$#a for(a +)n%+a $" !%agno$#%+a "n n%o$ !" (1 +or#a "!a! "n g"n"ra) !" 5 a

ao$ !"'%!o a B1" &a$an (aor #%"(&o 1gan!o "n $1")o$ +on#a(%na!o$ &or

") &"rro !" )a fa(%)%a 60J

La$ for(a$ a$%n#o(#%+a$ $on )a$ ($ fr"+1"n#"$ $%n "('argo "$ &o$%')"

!%agno$#%+ar)a$ a++%!"n#a)("n#" !a!o B1" &roFo+an )"1+o+%#o$%$ +on

"o$%nof%)%a$ B1" Faran !"$!" ") 50 a) >0 1 0 6J

Da!o B1" "n )a &r+#%+a !%ar%a ") ag"n#" "#%o)?g%+o no $" &1!" !"(o$#rar "$

+onF"n%"n#" ))a(ar a) +1a!ro +)n%+o* Sn!ro(" !" LarFa M%gran$ 8%$+"ra)


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S"g,n )o$ ?rgano$ o #"%!o$ B1" af"+#an &r"$"n#an $%gno$ $n#o(a$ !%F"r$o$

a)g1no$ !" "))o$ $" !"$+r%'"n a +on#%n1a+%?n9

Gnra"%9 f%"'r" a)#a (a)"$#ar g"n"ra) a$#"n%a !o)or a'!o(%na)

/p#&ca%9 /"&a#%#%$ o /"&a#o("ga)%a +on &r1"'a$ /"%+a$ )"F"("n#"

a)#"ra!a$ C1an!o $" !%$&on" !" r"$1)#a!o$ /%$#o)?g%+o$ &or )o g"n"ra) $" F"n

fo+o$ !" /"&a#%#%$ gran1)o(a#o$a Ta('%n $" /an r"&or#a!o +a$o$ !"

a'$+"$o$ /"%+o '%ogn%+o$ +on+o(%#an#" +on /"&a#%#%$ &or To@o+ara En )a

"+o#o(ografa )a r"$onan+%a n1+)"ar (agn#%+a $" &1"!"n "F%!"n+%ar fo+o$

gran1)o(a#o$o$ gran1)o(a$ !" +1"r&o "@#raoJ

L&nf#&co%9") 'ao "$ af"+#a!o +on ("no$ fr"+1"n+%a B1" ") /ga!o &"ro $"

r"&or#an +a$o$ !" "$&)"no("ga)%aK )a )%nfa!"no&a#a g"n"ra)%a!a

&r%n+%&a)("n#" "n )a+#an#"$ #a('%n &1"!" $"r 1n $%gno !" %nf"++%?n &or

To@o+ara "n $1 for(a F%$+"ra)

P$".onar9 $" &r"$"n#a #o$ +r%$%$ a$(a#%for(" +on $%'%)an+%a$ T%"n"n

&rogr"$%?n a n"1(ona "o$%n?f%)a )a %n$1f%+%"n+%a r"$&%ra#or%a a /a $%!o

r"&or#a!a En &r"$"n#a+%on"$ ag1!a$ )a for(a !" LM8 &1"!" $"r +onf1n!%!a

+on 1n )%nfo(a En )a$ ra!%ografa$ $" !"(1"$#ran %nf%)#ra!o$ &"r%/%)%ar"$

&)"1r"$a '%)a#"ra)

Car!aca9a1nB1" +on &o+a fr"+1"n+%a ") +ora?n &1"!" F"r$" af"+#a!o +on

"$#" &ar$%#o )a for(a ($ +o(,n "$ )a (%o+ar!%#%$ %n+)1$o +on %n$1f%+%"n+%a

+ar!%a+a #a&ona(%"n#o &"r%+r!%+o

Dr.a#o"+g&co9$" &1"!"n o'$"rFar !%F"r$a$ (an%f"$#a+%on"$ +1#n"a$ +o(o

1r#%+ar%a$ n?!1)o$ +")1)%#%$ /a$#a "+"(a g"n"ra)%a!o g"n"ra)("n#"

+r?n%+o$

En#r&ca9+1r$a +on anor"@%a n1$"a$ F?(%#o$ !o)or a'!o(%na)


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R$.a#o"+g&co%9&1"!"n &r"$"n#ar$" +o(o ar#ra)g%a$ (onoar#r%#%$ )"$%on"$

+1#n"a$ (%gra#or%a$ $%gno$ !" Fa$+1)%#%$

/.a#o"+g&co%9)a a)#"ra+%?n ($ fr"+1"n#" +a$% +on$#an#" "$ )a "o$%nof%)%a

.%g56J B1" g"n"ra)("n#" "$ $"F"ra (aor a 60 %n+)1$o !" 500K +on

+%fra$ !" )"1+o+%#o$ B1" &1"!"n "@+"!"r )o$ 500000(( a!"($ an"(%a

r"$1)#an#" !" )a %nf)a(a+%?n +r?n%+a O#ra$ a)#"ra+%on"$ $on*

"r%#ro$"!%("n#a+%?n a+")"ra!a /%&"rga((ag)og1)%n"(%a a1("n#o !"

%$o/"(ag)1#%n%na$ an#% A an#% 7

La /%&"rg)o'1)%n"(%a $" !"'" a B1" )a $1&"rf%+%" !" )a$ )arFa$ !" To@o+ara

Can%$ &o$"" an#g"no$ B1" r"a++%onan "n for(a +r1a!a +on )o$ gr1&o$

$ang1n"o$ A 7 )o B1" r"$1)#a "n &ro!1++%?n !" an#%+1"r&o$ ag)1#%n%na$J "n

)o$ &a+%"n#"$ %nf"+#a!o$ D" a+1"r!o +on "$#o $" &1"!" !"#"r(%nar ") ##1)o

$r%+o !" ag)1#%n%na$ an#%-A o an#%-7 " %n#"r&r"#ar ") r"$1)#a!o "n f1n+%?n !")

gr1&o $ang1n"o !") &a+%"n#" Nor(a)("n#" )a$ &"r$ona$ #%"n"n ##1)o$ !"n#ro

!" 1n rango a(&)%o an#%-A !" -20 an#%-7 !" -2


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F&g' 6:9 L"$%on"$ &a&1)o "r%#"(a#o$a$ "n r"g%?n a@%)ar an#"ro)a#"ra) !")#ron+o &or #o@o+ar%a$%$

;'7' LARVA MIGRANS OCULAR >LMOLa (an%f"$#a+%?n +)n%+a ($ graF" !" "$#a &ara$%#o$%$ "$ )a &r!%!a !" )aF%$%?n !") oo )"$%ona!o

E$#" $n!ro(" $" &r"$"n#a ($ +o(,n("n#" "n n%o$ (aor"$

La #o@o+ar%a$%$ o+1)ar $" !"$+r%'%? /a+" ($ !" 0 ao$ #ra$ ") "@a("n

ana#o(o&a#o)?g%+o !" ; oo$ "n1+)"a!o$ &or $o$&"+/a !" r"#%no')a$#o(a

;J En 2 !" "))o$ $" "n+on#raron )arFa$ o r"(an"n#"$ /%a)%no$ B1"

&o$#"r%or("n#" $" %!"n#%f%+aron +o(o )arFa !" #"r+"r "$#a!%o !" To@o+ara La

af"+#a+%?n $1")" $"r 1n%)a#"ra) rara F" '%)a#"ra) La )arFa %ngr"$a &or )o$

Fa$o$ ar#"r%a)"$ for(an!o 1n gran1)o(a >J La &r"$"n+%a !") ag"n#"

!"$"n+a!"na 1n +1a!ro %nf)a(a#or%o %n"$&"+f%+o B1" g"n"ra a1("n#o !" )a

+")1)ar%!a! #1r'%!" !") /1(or F#r"o La "Fo)1+%?n na#1ra) !") &ro+"$o

%nf)a(a#or%o &1"!" ))"Far a )a f%'ro$%$ +on r"#ra++%?n +%+a#r%a) !" )a r"#%na

)"1+o+or%a ;9J E) +o(&ro(%$o o+1)ar $" /a !"$+r%#o "n n%o$ (aor"$

a!1)#o$ $%n "o$%nof%)%a +on ##1)o$ 'ao$ !" an#%+1"r&o$ 26J


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C1r$a +on )"1+o+or%a 1F"#%$ gran1)o(a$ r"#%n%ano$ o "n!of#a)(%#%$ +r?n%+a

"$#ra'%$(o +on 1na %(&or#an#" !%$(%n1+%?n !" )a ag1!"a F%$1a) " %n+)1$o

&r!%!a #o#a) !" )a (%$(a E$ ($ fr"+1"n#" "n g"n"ra) "n n%o$ (aor"$ !"

50 ao$ $1")" +1r$ar $%n )a +ara+#"r$#%+a "o$%nof%)%a !" )a$ o#ra$ for(a$ !"

To@o+ar%a$%$

E) !%agn?$#%+o !" +"r#"a !" "$#a &a#o)oga $" +onf%r(a a) %!"n#%f%+ar )a )arFa "n

'%o&$%a$ a1#o&$%a$ o &or )o /a'%#1a) "n )o$ oo$ "n1+)"a!o$ En )a a+#1a)%!a!

") of#a)(?)ogo $" 'a$a "n )a $%(%)%#1! !" )a$ )"$%on"$ "n ") fon!o !" oo +on )a$

!"$+r%#a$ "n +a$o$ +onf%r(a!o$ &or /a))ago !" )arFa !" To@o+ara .%g 5


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2 Gran1)o(a !") &o)o &o$#"r%or

6 Gran1)o(a &"r%fr%+o

Co.p"&cac&on% H"(ogra(a* )"1+o+%#o$%$ "o$%nof%)%a$ Q50JH%&"rga(ag)o'1)%n"(%a IgG IgM IgA " IgEJ

A1("n#o !" %$o/"(oag)1#%n%na$ an#% A an#% 7 a 5*502J

S"ro)oga* ELISA 5*62J o +1a)%#a#%Fo $"g,n n!%+" !" M1"$#ra$ "$#"rn 7)o#

J! LMO

D"$&r"n!%(%"n#o !" r"#%na &or #ra++%?n

Ca#ara#a

H"(orrag%a$ $1'r"#%n%ana$

E$#ra'%$(o /%&o#ona

C"g1"ra

Co.p"&cac&on% ! "a To0ocar&a%&% Oc$"ar'

F&g' 6= - 6?9 Gran1)o(a$ &or #o@o+ar%a$%$

F&g' 6


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F&g' 6@9En!of#a)(%#%$ F&g' 7B9D"$&r"n!%(%"n#o !" r"#%na &or#ra++%?n To@o+ar%a$%$ O+1)ar

;'8' TOOCARIASIS NEUROLGICA

Pr"$"n#a (an%f"$#a+%on"$ B1" Faran $"g,n )a )o+a)%a+%?n !" )a$ )arFa$ B1"

a+#,an +o(o fo+o$ %rr%#a#%Fo$ &ro!1+%"n!o )"$%on"$ $%(%)ar"$ a &"B1"o$

#1(or"$ B1" &1"!"n !"$"n+a!"nar 1n %(&or#an#" +o(&ro(%$o n"1ro)?g%+o

+o(o "n+"fa)%#%$ ("n%ng%#%$ (%")%#%$ +onF1)$%on"$ "&%)"%for("$ #ra$#orno$

+on!1+#1a)"$ /%&o"$#"$%a$ &ara&ar"$%a$ F"%ga n"1r?g"na "$&$#%+a "

%n+)1$o /"(%&)"a


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29/75

=' DIAGNSTICO

E) !%agn?$#%+o !" )a %nf"++%?n /1(ana &or To@o+ara Can%$ r"$1)#a !%f%+1)#o$o

!"'%!o a B1" )a $%n#o(a#o)oga "$ %n"$&"+f%+a $%(%)ar a )a !" o#ra$ &a#o)oga$

") &ar$%#o a!1)#o no $" "n+1"n#ra "n /"+"$ a$ +o(o #a(&o+o $1$ /1"Fo$ ")

/a))ago !" )a$ )arFa$ "n #"%!o$ ("!%an#" '%o&$%a$ !" )o$ gran1)o(a$ "$ 1n

/"+/o "@+"&+%ona)

M1+/a$ F"+"$ )a ,n%+a (an%f"$#a+%?n )a "o$%nof%)%a B1" "n &"!%a#ra "$ 1n

%n!%+a!or /"(a#o)?g%+o B1" !"'%"ra ))"Far a "$#1!%ar $1 "#%o)oga 6J En#r"

"))a$ #"n"r &r"$"n#" a) To@o+ara Can%$ E$#a "$ 1na for(a %n!%r"+#a !" ))"gar a)

!%agn?$#%+o

Por )o #an#o /a$#a ") (o("n#o )a !"(o$#ra+%?n !" an#%+1"r&o$ "$&"+f%+o$ "n

$1"ro "$ )a /"rra(%"n#a ($ ,#%) +onf%a')" S" 1#%)%a ") (#o!o

"n%(o%n(1noan)%$%$ ELISA a !"$!" 59>9 +on 1na a)#a $"n$%'%)%!a!

"$&"+%f%+%!a! E) !%agn?$#%+o &or ELISA $" +on$%!"ra &o$%#%Fo a &ar#%r !") ##1)o

562


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E$ !" !"$#a+ar B1" "n n1("ro$o$ +a$o$ !" LMO )a $"ro)oga &1"!" no $"r

+on+)1"n#" )o$ an#%+1"r&o$ $r%+o$ $" &r"$"n#an "n 'ao$ n%F")"$ o $" /a))an

a1$"n#"$ &or )o B1" $1 +onf%r(a+%?n &1"!" r"a)%ar$" ("!%an#" )a !"#"++%?n !"

an#%+1"r&o$ "$&"+f%+o$ an#%-Toxocara &ro!1+%!o$ )o+a)("n#" "n ") oo /1(or

a+1o$o o F#r"oJ La ("nor $"n$%'%)%!a! !") E)%$a "n ") !%agn?$#%+o !"

#o@o+ar%a$%$ o+1)ar $" !"'" &o$%')"("n#" a )a ("nor +on+"n#ra+%?n !"

an#%+1"r&o$ "n ") $1"ro !" )o$ &a+%"n#"$ &orB1" )a +an#%!a! !" )arFa$ "$

#a('%n ("nor o &orB1" /a &a$a!o 1n )argo &"ro!o !" #%"(&o "n#r" )a

%nf"++%?n %n%+%a) )a$ (an%f"$#a+%on"$ o+1)ar"$


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F&g' 76* E+ografa +or#" )ong%#1!%na) !" )"$%?n no!1)ar &or To@o+ara

F&g'779E+ograf%a !o&&)"r +o)or (%$(a)"$%?n B1" )a an#"r%or


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F&g'789To(ografa

F&g' 7:97%o&$%a* #"%!o gran1)(a#o$o )arFa!" To@o+ara


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?' TRATAMIENTO

M1+/o$ a1#or"$ $o$#%"n"n B1" )a (aora !" )o$ &a+%"n#"$ no r"B1%"r"n

#ra#a(%"n#o a no $"r )a$ for(a$ graF"$ o $%n#o(#%+a$ J

An#"r%or("n#" )a &r%("ra )n"a 1#%)%a!a f1" )a !%"#%)+ar'a(a%na a ra?n !" 25J f1" ana)%a!o &or 1n 'a+#"r%?)ogo

D%+/o #"$# +1(&)%? )o$ $%g1%"n#"$ &ar("#ro$ !" +a)%!a!*

S"n$%'%)%!a! !") 500 "$&"+%f%+%!a! !") 9

E$#" (#o!o "$ 1n #"$# !" "n%(o%n(1no"n$ao &ara )a %!"n#%f%+a+%?n

+1a)%#a#%Fa !" an#%+1"r&o$ IgG +on#ra To@o+ara +an%$ "n ") $1"ro /1(ano

REALIZACI4N DEL TEST*

1. S" a1$#? )a (%+ro&)a+a !" #%#1)a+%?n r"a+#%Fo$ a #"(&"ra#1ra

a('%"n#" 20 2


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11. S" #ran$f%"r" a +a!a +aF%!a!


45/75

7'?'6' VARIA3LES

8ar%a')" T%&o D"f%n%+%?n o&"ra#%Fa

E!a! C1an#%#a#%Fa M"$"$ !" F%!aLa+#an#"* 0- 2 ao$Pr""$+o)ar* 6- < ao$E$+o)ar*;- 9 ao$A!o)"$+"n#"* 50 -5< ao$

S"@o C1a)%#a#%Fa Ho('r" o (1"r

H"&a#o("ga)%a C1a)%#a#%Fa Maor a 2 +( $% noJ

A!"no("ga)%a C1a)%#a#%Fa Maor a 5< +( $% noJ

.%"'r" C1a)%#a#%Fa S"n$a+%?n f"'r%) r"&or#a!a&or )a (a!r"$% noJ

An"(%a C1a)%#a#%Fa M"nor a 55 $% noJ

Eo$%nof%)%a C1a)%#a#%Fa L"F"* !"


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RESULTADOS

6'Carac#r%#&ca% !.ogrf&ca% ! "o% pac&n#%6'6 C"a%&f&cac&+n ! pac&n#% &ngr%a!o% a" %#$!&o %gKn "a

proc!nc&a'

D" )o$ ; &a+%"n#"$ 6; &roF"nan !" )a +%1!a! !" I#a1g1a 62 !" )a +%1!a! !"

P%r%'"'1K a('a$ &"r#"n"+"n a) r"a r1ra)

Grf&co 69 D%$#r%'1+%?n !" &a+%"n#"$ %ngr"$a!o$ a) "$#1!%o !" #o@o+ara +an%$

$"g,n $1 &ro+"!"n+%a

.1"n#"* F&cJa C"n&ca

6'7' D&%#r&1$c&+n ! pac&n#% %#$!&a!o% %gKn " %0o'

PROCEDENCIA


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D") #o#a) !" &a+%"n#"$ 6


48/75

D" )o$ ; n%o$ "$#1!%a!o$ 2565J "$#1F%"ron "n )a frana !" ; -9 ao$ 20

n%o$ "n#r" 6-< ao$ aB1"))o$ +o(&r"n!%!o$ "n#r" 50 5< ao$ f1"ron 5;J

Ca$% "n $1 #o#a)%!a! "$#o$ n%o$ #%"n"n o /an #"n%!o +on#a+#o +on an%(a)"$

!o($#%+o$ (a$ "$&"+f%+o +on &"rro$ o ga#o$ "$ (a$ +onF%F"n +on "))o$

"$#o "$ 1n fa+#or !" r%"$go %(&or#an#" &ara ") +on#ag%o +on /1"Fo$ !" #o@o+ara

6J

La '%')%ografa $"a)a B1" )a #o@o+ar%a$%$ $" F" faFor"+%!a &or a('%"n#"$

$o+%o"+on?(%+o$ +ar"n+%a!o$ /a+%na(%"n#o &o+o %n$#r1%!o$K "$#o$ fa+#or"$ no

f1"ron "Fa)1a!o$ "n "$#" "$#1!%o 6; ;9 >0>5J


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En +1an#o a) $"@o !" n1"$#ro$ &a+%"n#"$ /1'o 1na !%$#r%'1+%?n +a$% &ar"a +on

1na &"B1"a !%f"r"n+%a a faFor !") f"("n%no &"ro $%n (1+/a r")"Fan+%a

#a(&o+o "@%$#"n !a#o$ "n )a )%#"ra#1ra o "n "$#1!%o$ $%(%)ar"$ B1" %n!%B1"n 1na

%n+%!"n+%a (aor &ara a)g1no !" )o$ $"@o$

Lo$ r"$1)#a!o$ o'#"n%!o$ "n "$#" "$#1!%o (1"$#ran 1na a)#a &r"Fa)"n+%a !"

%nf"++%?n &or #o@o+ara +an%$ "n n%o$ "n $1 (aora )o$ !" "!a! "$+o)ar

+o(&r"n!%!a "n#r" > ao$ $"g1%!a (1 !" +"r+a &or )o$ !" &r"-"$+o)ar 0 a

ao$K +o%n+%!%"n!o +on )a fr"+1"n+%a r"f"r%!a "n )a )%#"ra#1ra 60J E$#o &1"!"

!"'"r$" a )o$ /'%#o$ !" )o$ n%o$ "n "$#a "!a! +o(o )a g"ofag%a o &%+a

!"$+ono+"r )a for(a !" )aFar$" a!"+1a!a("n#" )a$ (ano$ 1gar )a (aor

&ar#" !") #%"(&o "n ") $1")o ))"Far o'"#o$ +on#a(%na!o$ a )a 'o+a o &or ")

+on$1(o !" F"g"#a)"$ fr1#a$ +r1!a$ (a) )aFa!a$ >62 >2J

S"g,n )o &1')%+a!o "n )a )%#"ra#1ra )a (aora !" )o$ +a$o$ !" #o@o+ar%a$%$ $on

a$%n#o(#%+o$ > "n n1"$#ro "$#1!%o +1an!o $" (an%f%"$#an )o$ $%gno$

+)n%+o$ /a'%#1a)("n#" "n+on#ra!o$ $on /"&a#o("ga)%a a!"no("ga)%a f%"'r"

2 62JK 556 5


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&ar#%+1)ar("n#" $+ar%$ &1"!" +onf%r(ar$" &or ") "$#"rn 7)o# &"ro $o)o "n

+a$o$ !1!o$o$ a B1" ") ELISA "$ a)#a("n#" "$&"+f%+o $"n$%')" 65


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CONCLUSIN

A &ar#%r !") &r"$"n#" #ra'ao &o!"(o$ +on+)1%r*

La %nf"++%?n &or To@o+ara Can%$ "n n1"$#ra &o')a+%?n "$ a)#a >J

La for(a +)n%+a a$%n#o(#%+a f1" )a ($ fr"+1"n#"K "n 1na B1%n#a &ar#"

$" "n+on#r? af"+#a+%?n !") $%$#"(a r"#+1)o"n!o#")%a) +o(o

/"&a#o("ga)%a a!"no("ga)%a

En ($ !" )a (%#a! !" )o$ +a$o$ $" +on$#a#? )a &r"$"n+%a !" Eo$%nof%)%a

$%"n!o )a $"F"ra )a ($ fr"+1"n#"

La an"(%a $" +on$#a#? "n 1n 'ao &or+"n#a"

Una "o$%nof%)%a $"F"ra !"'" !"$&"r#ar ") n!%+" !" $o$&"+/a &ara

%nF"$#%gar To@o+ara Can%$ "n#r" o#ra$ &ara$%#o$%$

Por #o!o )o "@&1"$#o #"r(%no*

La #o@o+ar%a$%$ "$ 1na "nf"r("!a! +o(&)"a (1+/a$ +1"$#%on"$ "$#n

a,n $%n r"$o)F"r* $" !"$+ono+" )a /%$#or%a na#1ra) !" )a %nf"++%?n "n )o$

&a+%"n#"$ a$%n#o(#%+o$ B1 &a+%"n#"$ &r"$"n#arn +o(&ro(%$o o+1)ar +1)

"$ )a 1#%)%!a! !") #ra#a(%"n#o &ara &r"F"n%r ") !"$arro))o !" )"$%on"$ o+1)ar"$

S" &)an#"a )a n"+"$%!a! !" r"a)%ar "$#1!%o$ +on#ro)a!o$ +on $"g1%(%"n#o a

)argo &)ao &ara +ono+"r )a "Fo)1+%?n Fa)orar )a "f%+a+%a !") #ra#a(%"n#o

"$&"+%a)("n#" "n aB1"))o$ n%o$ a$%n#o(#%+o$

A!"($ $" &r"#"n!" ))a(ar )a a#"n+%?n !" Sa)1! P,')%+a &ara %nF"r#%r "n ")

!%agn?$#%+o !" "$#a "n#%!a! a B1" "$ !" 1na &r"Fa)"n+%a %(&or#an#" a) ("no$

"n r"a r1ra) "n ("!%!a$ !" "!1+a+%?n &r"F"n+%?n


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E$&"ro B1" "$#" #ra'ao $"a ") %n%+%o !" (1+/o$ o#ro$ $%"(&r" &or ") '%"n

!" n1"$#ro$ n%o$

3I3LIOGRAF2A

5 P")ao D1rn L G"n"ra)%!a!"$ !" &ara$%#o)oga M%+ro'%o)oga &ara$%#o)oga (!%+a La Ha'ana 2005K #o(o III 6 25

2 Monro" L Par$%#o$ !") #1'o %n#"$#%na) !") /o('r" Ga$#ro"n#"ro)oga 6]"! La Ha'ana 59;K -59

6 To)an R La1f"r M To@o+ar%a$%$ M"!$+a&"^$ Con#%n1a)) U&!a#"! C)%n%+a)R"f"r"n+" En"ro 2009

Sar"!% N Man1a) &r+#%+o !" Para$%#o)oga M!%+a 5] "!- 71"no$ A%r"$KLa'ora#or%o An!r?(a+o 2002K >5->6


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50 Hoa$ M%)ano$% A To@o+ar%a$%$ - an 1n!"r"$#%(a#"! &ro')"( %n&a"!%a#r%+$ M"! %"1 Roo 2002K;2J*5-660

5G)%+(an LT C/a1!r IU Con$#an#%no 3 C)a+ .7 C&"$$ RH %n$)o LP%+a &a##"rn$ To@o+ar%a$%$ an! ")"Fa#"! ')oo! )"a! %n +/%)!r"n A( 3 Tro& M"!Hg 595K 60*>>-0

552J*5-

5> T/o(&$on DE 71n! DA Coo&"r ES S+/an# PM E&%!"(%o)og%+a)+/ara+#"r%$#%+$ of Toxocara canis oono#%+ %nf"+#%on of +/%)!r"n %n a Car%''"an+o((1n%# 71)) or)! H"a)#/ Organ 59;K ;2J* 26-290

5 7a'oo)a) S Ra)%n$ SC'S"ro&r"Fa)"n+" of #o@o+ar%a$%$ %n $+/oo) +/%)!r"n%n Tr%n%!a! Tran$ R So+ Tro& M"! Hg 2002K 9; 2J* 569-56


67/75

59 Mon#a)Fo AM E$&%no AM E$+a)an#" G .%n)a CM S#1! of #/"$"ro&r"Fa)"n+" of #o@o+ar%a$%$ %n an %nfan#%)" &o&1)a#%on %n #/" C%# of HaFanaR"F C1'ana M"! Tro& 599K ;6J*5K 9*


68/75

2 Ho))an! C O^Lor+a%n P Ta)or M ")) A S"ro"&%!"(%o)og of #o@o+ar%a$%$%n $+/oo) +/%)!r"n Para$%#o)og 599;

6


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69 Gar+a M Da O Pr"Fa)"n+%a !" %nf"++%?n &or Toxocara"n &r"-"$+o)ar"$ !" 1na +o(1n%!a! "!1+a#%Fa !" E) Mon ' Un%F"r$%!a! !")Z1)%a Mara+a%'o 8"n"1")a 200

0 oo!r1ff A So%) for "gg$ of Toxocara $&"+%"$ Ann Tro& M"! Para$%#o)592K >;* -0*52


70/75

O_+onnor P 8%$+"ra) )arFa (%gran$ of #/" E" Ar+/ O&/#/a)-8o) NoF59>2

9 Zg1)$a-Mar+/ H r1ar-7a$#"r Z%o'ro$% S O+1)ar To@o+ar%a$%$ %n+/%)!r"n an! o1#/ Do+ O&/#/a)(o) 5996K2 J* 5


71/75

L?&" M L Mar#%n G To@o+ar%o$%$ "n n%o$ !" 1na r"g%?n $1'#ro&%+a)R"F%$#a !" M"!%+%na 71"no$ A%r"$ 200


72/75

;> C/a(orro M S#"% M A)on$o 3 Con#a(%na+%?n !" &)aa$ &,')%+a$ !"R"$%$#"n+%a Arg"n#%naJ +on /1"Fo$ !" Toxocara $&& =II Congr La#%noa(Para$%#o) San#%ago-C/%)" 5992 ATIAS A Para$%#o)oga C)n%+a P1')%+a+%on"$ T+n%+a$ M"!%#"rrn"a$ L#!aSan#%ago !" C/%)" 6] E!%+%?n 5995K ;5

>6 ."no S C1"))ar C Ag1%)a C G1%))n3 L P"r$%$#"n+" of %((1n" r"$&on$"%n /1(an #o@o+ar%a$%$ a$ ("a$1r"! ' ELISA In# 3 Para$%#o) 5992K 22 *506>-506


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ANEXOS

Reactivos paa !etecci"# !e a#tic$epos %&' a#ti oocaa *a#is

+icopaca


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Reaccio#es positivas


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ESTUDIO DE PRE8ALENCIA DE SEROPOSITI8IDAD PARA TO=OCARA

CANIS EN NI`OS DE PO7LACIONES RURALES* ITAUGUA Y PIRI7E7UY

AUTORIZACI4N DEL PACIENTE

Por )a &r"$"n#" a1#or%o a )o$ (!%+o$ !") Ho$&%#a) Na+%ona) B1" "f"+#,"n )o$

&ro+"!%(%"n#o$ )a'ora#or%a)"$ n"+"$ar%o$ "n+a(%na!o$ a !"#"+#ar )a &o$%')"

%nf"$#a+%?n +on &ar$%#o$ !") gn"ro To@o+ara Can%$

Co(&r"n!o B1" !%+/o$ "$#1!%o$ $" 1#%)%arn "n ") (ar+o !" 1na %nF"$#%ga+%?n

"&%!"(%o)?g%+a a+"o )o$ r%"$go$ &ro&%o$ !") &ro+"!%(%"n#o a B1" $o("#o a)

n%o

Ma!r" o &a!r" !") n%o .%r(a !" )a &"r$ona r"$&on$a')"Do+ !" I!"n#%!a! Do+ !" I!"n#%!a!

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