Egy ritka zoonosis: a Schistosoma turkestanicum vérmétely által okozott cercaria dermatitis Magyarországon | A rare zoonosis in Hungary: cercarial dermatitis caused by Schistosoma turkestanicum blood-fluke

Absztrakt Az allatokban sok metelyfaj el, amelyek larvaja a gazda bőren keresztul fertőzi azt. Ezek kozul az ember szempontjabol a legfontosabbak az emlősok vermetelyei, mert belőluk kerulnek ki az embert fertőzni kepes vermetelyek is. Tobb fajuk a tropusi orszagok lakoinak rettegett schistosomosisat okozza, mig mas fajok behatolnak ugyan az ember bőrebe, de adultta nem valnak a testeben. A mersekelt egovben főleg az utobbi, bőrgyulladas formajaban jelentkező infekcio fordul elő. A metelylarvak eredete legtobbszor nem tisztazhato, ezert altalaban sem orvosok, sem allatorvosok nem foglalkoznak a fertőzes forrasaval. Szarvasokban elő metelyfajrol bizonyitottuk be, hogy a regen „vizi ruhosseg”-nek nevezett bőrbantalmat csigakbol kirajzo cercariak okozzak. A Duna egyik arteren endemikus Schistosoma turkestanicum okozta dermatitis ritkan kerul orvos szeme ele, pedig informalis kozlesek alapjan ugy tűnik, hogy rendszeresen előfordulo tunet a metely előhelyen levő vizekben halaszo vagy furdőző embereken. Rautalo korelőzmeny eseten indokolt a human vermetely-fertőzottseghez hasonlo szerologiai reakciot ado cercaria dermatitis eredetet kivizsgaltatni. Orv. Hetil., 2016, 157(40), 1579–1586. | Abstract Several trematodes that parasitize vertebrate animals utilize swimming aquatic larvae to infect the host percutaneously. The most important ones among these parasites are the blood-flukes of birds and mammals comprising species that are also zoonotic. Within this latter group are species that cause the bilharziasis or schistosomiasis of inhabitants of the tropical countries, and other trematode species that are able to penetrate human skin, but do not develop to an adult form of the worm in the body. In temperate climates this latter type of infection occurs mainly in the form of an unpleasant inflammation of the skin and is often called “swimmer’s itch”. In most of these cases, the origin of the larvae remains unexplored, the source of the infection is neglected by the medical or veterinarian practitioners. Herein we report for the first time in Hungary that the cause of such dermatitis was the cercariae of Schistosoma turkestanicum, which infected red deer (Cervus elaphus) in this country. The local name of this pristine disease is “water mange” and it occurs only in one of the floodplains of the Danube. On the basis of informal communication this symptom seems to be rather regular among people who do fishing or have a bath in the habitat of the blood-fluke. In the case of adequate anamnesis it is worth examining the origin of the cercarial dermatitis which may give cross-reactions with human schistosomiasis during serological tests. Orv. Hetil., 2016, 157(40), 1579–1586.