Infestations and chronic infections in foreign pediatric patients with burns: Is there a role for specific protocols?

Infestations by parasites such as Mycobacterium tuberculosis and other vira l infections are common in third world countries. Consequently, the admissi on of a significant number of foreign patients to burn centers in the Unite d States may pose new problems, not only for inpatients but also for health care workers. To document infestations in patients from third world countr ies and to determine the need for specific protocols, we studied 62 consecu tive foreign patients admitted to our pediatric burn reconstruction service between July 1997 and December 1998. All patients were evaluated with ches t X-ray, hemogram with differential count, clinical and laboratory nutritio nal assessment, and skin test for tuberculosis, and stool samples were eval uated for ova and parasites. No pathologic findings were seen on chest radi ographs, Only 1 patient had a positive skin test for tuberculosis, as a res ult of previous bacille Calmette-Guerin vaccine. Yet, 10 patients (16%) bad positive stool cultures for ova and parasites that contained 29 isolates. The most frequently identified organism;sm was Blastocystis hominis. All am oebas identified were nonpathogenic according to Centers for Disease Contro l criteria. Ascaris lumbricoides and 1 case of cysticercosis were found. No ne of the patients with parasites had clinical manifestations of parasitosi s or chronic infections. However, parasite infestations had a positive corr elation with eosinophilia, altered nutritional status, and altered mean cor puscular hemoglobin concentration, as defined by multiple linear regression . Although foreign patients admitted to burn centers from third world count ries have a low rate of infestations, patients at risk can be identified by laboratory findings and studies of nutritional status. Simple hand washing prevents the spread of disease and protects health providers.