Parasites and musculoskeletal system

Abstract

Introduction. Musculoskeletal impairment in parasitic infections are rare diseases more found in tropical countries. With the migration and seasonal travel of the population, many diseases considered exotic are becoming frequent in our country. In Republic of Moldova, musculoskeletal disorders have been observed in infections caused by Toxocara canis, Giardia lamblia and Echinococcus granulosus. Although a large number of clinical cases of locomotor system involvement in parasitic infections are described in the literature, systematic researches are lacking in this field. Aim of the study. To analyse particularities of musculoskeletal impairment in parasitic infections. Materials and methods. We included in our study 40 patients with musculoskeletal disorders who were diagnosed positively with different parasites (toxocara canis (18 subjects), toxocara cati (4), echinococcus granulosus (10), giardia intestinalis (4), ascaris lumbricoides (2) and 2 patients ascaris lumbricoides (asocieted with toxocara canis). The study included 19 men (47.5%) and 21 women (52.5%). The age of the patients varies from 18 to 63, the average age being 39 years. Patients were investigated clinically and paraclinically for the exclusion of other causes of musculoskeletal impairment and for the evaluation of pathological changes. Results. In the group of analyzed subjects 27 patients (67,5%) presented diffuse myalgia; 26 patients (65%)-localized muscle pain; 36 patients (90%)–joint pain of which 19.4%- monoarthritis, 55.6%-oligoarthritis, 25%-polyarthritis; 14 patients (35%) had swollen joints; 8 patients (20%)-reduction of joint mobility; 20 patients (50%) experienced bone pain and 95% (38 patients) had marked fatigue. From the monitored laboratory tests we mention: Level of total immunoglobulin E was greater than 240 ng/ml in 29 (72,5%) of subjects; total protein C was greater than 5 mg/l in 32 (80%); ESR was increased in 24 (60%) patients; eosinophils with values greater than 5% were in 38 (90%) subjects. Conclusions. The pathology of the locomotor system is found in parasitosis having as substrate inflammatory, immune and allergic changes with various sites of musculoskeletal pathology. In cases of musculoskeletal impairment of non-elucidated etiology, parasitic investigation should be considered for prompt decision of therapeutic management.