Diniz-Santos Daniel R, Jambeiro Jamile, Mascarenhas Ramiro R, Silva Luciana R
Pediatric Gastroenterology and Hepatology Division, Professor Hosannah de Oliveira Pediatric Center, Federal University of Bahia, Salvador, Brazil.
J Trop Pediatr. 2006 Feb;52(1):66-8. doi: 10.1093/tropej/fmi073. Epub 2005 Jul 6.
The differential diagnosis of chronic diarrhea is extensive and requires the investigation of several diseases, such as celiac disease, inflammatory bowel disease and irritable bowel syndrome. A few patients infected by Trichuris trichiura may present a chronic dysentery-like syndrome in the context of a massive infestation of the colon leading to anemia and growth retardation, but the rarity of that finding demands a high level of suspicion. Herein we report the case of an 8-year-old boy from the rural zone who had suffered diarrhea without blood or mucus for 4 years and was taken to our Service because his mother had noticed the presence of blood on the feces on the 3 previous months. The diagnosis of a massive Trichuris trichiura infestation as the cause of the process was only reached by colonoscopy. We stress that Trichuris trichiura infection can mimic other forms of inflammatory bowel disease and lead to physical growth retardation and that prolonged regimens of albendazole may be required to the effective treatment of massive infestations.
慢性腹泻的鉴别诊断范围广泛，需要对多种疾病进行调查，如乳糜泻、炎症性肠病和肠易激综合征。少数感染毛首鞭形线虫的患者在结肠大量感染的情况下可能会出现类似慢性痢疾的综合征，导致贫血和生长发育迟缓，但这种情况罕见，需要高度怀疑。在此，我们报告一例来自农村地区的8岁男孩，他腹泻4年，无血便或黏液便，因母亲在前3个月发现其粪便中有血而前来我院就诊。通过结肠镜检查才确诊为大量毛首鞭形线虫感染是导致该病程的原因。我们强调，毛首鞭形线虫感染可模仿其他形式的炎症性肠病并导致身体生长发育迟缓，有效治疗大量感染可能需要延长阿苯达唑治疗方案。
