Problem lambliozy w klinice pediatrycznej

The present work contains a summing up of observations of infections with lamblias made at the II Clinic for the Discases oi Children of the Medical Academy in Łódź and at the Clinical Parasitological Consultation Division for Children during the years 1960-1961. There were recorded 78 cases of infection with lamblias in children at the age 1-2 years 5 cases, 3-6 years 22 cases und 7-8 years 51 cases. The youngest of the observed children was 16 months. The most common clinical symptoms were: abdominal pains, irregular stools, loss of appetite, nausea and vomits, deficient body weight, paleness of the skin and mucous membranes, the so called nervousness, enlargement of the liver. In several cases was observed nocturnal urinalion, in one case nervous tics of the facial muscles and in one case attacks oi petit mal. In the majority or the cases we were dealing with chronic intestinal forms. In 27 children were found eysts of lamblias in the faces, in the remaining children the diagnosis had to be confirmed by the examination of the duodenal contents. We have not observed a relatively high anaemia neither an elevated leucocytes count. The percentage of the eosinophil blood corpuscles was various, on the average 3-10 per cent. The proteinogram showed in 11 children an increase of globulins, the albumin globulin ratio was 1 :1. We found in two cases radiological changes in the alimentary tract, in one case in the form of a gastric ulcer in the second in the form of a duodenal diverticulum. (A description in the original paper). The examination of the gastric contents revealed in 9 children a decrease of the acidity of the gastric juice. The liver tests were in 31 cases negative, in 17 dubious and only in 12 cases positive. In two children treated with too large doses of atebrin it was observed that the skin had a yellowy colour, the liver tests were negative and the symptoms of overdosage receded following tne administration of vitamin B2 a 50 mg. in intramuscular injections in the course of 3-5 days. All children were treated with atebrin in the typical form. Following three times repeated systematic cure the majority of the children was feeling quite well. In cases when the duodenal contents proved to be free of the vegetative forms such pabents were regarded as cured and it was suggested that further they should receive prophylactically atebrin in amount 0,1 x in month for at least 3 months. Out of the total number of 78 observed, only in 27 cases complete cure was attained. Among the 19 cases treated irregularly and with intervals, finally in 9 cases also complete cure was attained, confirmed by negative results of the examination of the faeces and duodenal contents. Twenty four children received one or two complete treatments but they did not call any mare for ambulatory control and were not admitted to hospital. They were not inhabitants of Łódź and mostly they were from provinces lying outside the Łódź province. In 8 cases the possibility of infection with the lamblias was excluded. Children in a poor physical condition, with anaemia, restlessness and nervousness on the border of neuropsychic disturbance were given atebrin under the cover of intravenous injections of a 20 per cent solution of glucose and vitamin C, or kamochin was administered because it does not injure the liver and kidneys. During intervals between treatments we have administered with great success vitamins of the B complex group, litrison, yeast, hydrochloric acid. Finally the difficulties are stressed which result from the long lasting treatment, indispensable systematic procedure and lack of full security during the treatment with atebrin of children, espccially under ambulatory conditions.