J Korean Med Assoc.  2016 Sep;59(9):721-734. 10.5124/jkma.2016.59.9.721.

Medical treatment of tropical parasitic diseases

Affiliations
  • 1Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Department of Molecular Parasitology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. kongy@skku.edu

Abstract

In Korea, patterns of parasitic infections have notably changed during the past few decades. The soil-transmitted helminthiases and water-borne protozoan infections, which had been prevalent, became negligible, while parasitic zoonosis including pet-associated infections, food-borne helminthiases, and imported tropical endemic diseases have increasingly been detected. People who travel abroad and those who have immigrated from other countries might suffer from endemic tropical diseases. Except for a few entities, which invoked acute febrile illness (malaria) and diarrhea (giardiasis and amoebiasis), most helminthic and protozoan infections did not provoke acute symptoms. Those infections progress slowly, but can sometimes result in fatal clinical consequences. Diverse tropical endemic diseases are prevalent in several continents/countries according to different natural environments (climate and humidity), socioeconomic status, and traditional cultural background. Those diseases might be acquired through different routes of infection. Travelers who have returned to Korea from overseas and immigrants should undergo a careful differential diagnosis. Information on countries and duration of travel/residence, food habits, underlying medical history, prophylactics received, exposure to harmful environments (insect bites, contaminated food or water), and swimming in freshwater is valuable. This article briefly overviews the epidemiology, pathophysiology, clinical manifestations, diagnosis, and specific chemotherapeutics of the tropical endemic diseases that are important in Korea.

Keyword

Travel; Immigrants; Tropical endemic diseases; Imported parasitic infections; Chemotherapeutics

MeSH Terms

Diagnosis
Diagnosis, Differential
Diarrhea
Emigrants and Immigrants
Endemic Diseases
Epidemiology
Food Habits
Fresh Water
Helminthiasis
Helminths
Humans
Korea
Parasitic Diseases*
Protozoan Infections
Social Class
Swimming

Figure

  • Figure 1 Distribution map of important tropical endemic diseases along with continents.

  • Figure 2 Representative ultrasonographic findings of cystic echinococcosis (CE) and alveolar echinococcosis (AE) with progression of the diseases. (A) CE1 stage shows unilocular hypodense cyst with a double line sign. CE2 cyst demonstrates multivesicular, multiseptated cysts with detached endocysts. CE3 stage displays unilocular cysts with daughter cysts that contained a solid cyst matrix/detached endocyst. CE4 cyst exhibits canalicular structure (ball of wool appearance). CE5 stage reveals heavily degenerative cyst with calcified wall. (B) Early stage of AE shows clusters of multiple echogenic small cysts with an indistinct margin (multiple small hailstorm-like cysts without a solid component). Advanced stage AE demonstrates an irregular cystic area combined with central necrosis surrounded by peripheral nonhomogenous echogenicity.


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