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改善中国输入性血吸病的管理:一例多次误诊的教训。

Improving the management of imported schistosomiasis haematobia in China: lessons from a case with multiple misdiagnoses.

机构信息

Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi City, Jiangsu Province 214064, People's Republic of China.

出版信息

Parasit Vectors. 2013 Sep 11;6(1):260. doi: 10.1186/1756-3305-6-260.

Abstract

BACKGROUND

Human Schistosoma haematobium infection that causes urinary schistosomiasis occurs in Africa and the eastern Mediterranean, and China is only endemic for S. japonicum. In this report, we reported an imported case with S. haematobium infection returning from Angola to Shaanxi Province, northwestern China, where S. japonicum is not endemic.

FINDINGS

The case was misdiagnosed as ureteral calculus, invasive urothelial carcinoma and eosinophilic cystitis in several hospitals, and was finally diagnosed by means of serological assay followed by microscopic examination of the urine sediment. The patient was then treated with praziquantel, and a satisfactory outcome was obtained.

CONCLUSIONS

As S. haematobium is not indigenous to China, most Chinese doctors and medical technicians are unfamiliar with this introduced parasitic disease, therefore, they need to increase the awareness of its existence when they encounter persons who have visited or resided in endemic areas, and the techniques for detection of the parasite, so as to reduce the misdiagnosis. In addition, health education should be given to those who will go to the endemic areas to improve their knowledge and awareness on prevention and control of schistosomiasis haematobia, thereby reducing the risk of exposure to the infested freshwater.

摘要

背景

引起尿路血吸虫病的人体曼氏血吸虫感染发生在非洲和地中海东部,而中国仅流行日本血吸虫。在本报告中,我们报告了一例从安哥拉返回中国西北地区的输入性曼氏血吸虫感染病例,中国西北地区非日本血吸虫流行区。

发现

该病例在几家医院被误诊为输尿管结石、浸润性尿路上皮癌和嗜酸性膀胱炎,最终通过血清学检测和尿液沉淀物显微镜检查进行诊断。然后,患者接受了吡喹酮治疗,取得了满意的疗效。

结论

由于曼氏血吸虫并非中国土生土长,大多数中国医生和医疗技术人员对这种输入性寄生虫病并不熟悉,因此,当遇到曾去过或居住在流行区的人时,他们需要提高对该病存在的认识,以及检测寄生虫的技术,以减少误诊。此外,应向即将前往流行区的人开展健康教育,提高他们对防治曼氏血吸虫病的知识和认识,从而降低接触受感染淡水的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c28/3848274/7d8f176ce479/1756-3305-6-260-1.jpg

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