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[急性阑尾炎合并蛲虫病和绦虫病感染:一例报告]

[Acute appendicitis and coinfection with enterobiasis and taeniasis: a case report].

作者信息

Çallı Gülhan, Özbilgin Mücahit, Yapar Nur, Sarıoğlu Sülen, Özkoç Soykan

机构信息

Dokuz Eylül Üniversitesi Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye.

出版信息

Turkiye Parazitol Derg. 2014;38(1):58-60. doi: 10.5152/tpd.2014.3174.

Abstract

Parasites are rarely associated with inflammation of the appendix. Generally, parasites cause acute abdominal pain via blocking the gut lumen. In this article, we presented a case of appendicitis where Enterobius vermicularis was detected in the surgical specimen and Taenia was detected in the stool. A 31 year old male patient was admitted to the emergency room with severe abdominal pain, which has begun two days ago. On physical examination, tenderness was positive on palpation of the right lower abdominal quadrant and the patient was operated on with the diagnosis of acute appendicitis. Histopathological examination of the patient's appendectomy material revealed numerous parts of parasites resembling Enterobius vermicularis and slight mucosal erosion. On parasitological examination of the patient's stool, Taenia eggs and adult forms were determined. Antiparasitic therapy was started with niclosamide for taeniasis and albendazole for enterobiasis. Parasitic infections can mimic acute appendicitis clinically. Radiological and laboratory findings do not help to distinguish the diagnosis of acute appendicitis. In the histopathological examination of the appendix, the findings of acute inflammation of the appendix wall may not be defined. For patients with normal histopathological examination, screening for parasites should be done, and anti-parasitic treatment should be started after appendectomy.

摘要

寄生虫很少与阑尾炎相关。一般来说,寄生虫通过阻塞肠腔引起急性腹痛。在本文中,我们报告了一例阑尾炎病例,手术标本中检测到蛲虫,粪便中检测到绦虫。一名31岁男性患者因严重腹痛两天前入院急诊。体格检查时,右下腹触诊压痛阳性,患者因急性阑尾炎诊断接受手术。患者阑尾切除材料的组织病理学检查显示有许多类似蛲虫的寄生虫部分以及轻微的黏膜糜烂。对患者粪便进行寄生虫学检查时,发现了绦虫卵和成虫形态。针对绦虫病开始使用氯硝柳胺进行抗寄生虫治疗,针对蛲虫病开始使用阿苯达唑进行治疗。寄生虫感染在临床上可能会模仿急性阑尾炎。影像学和实验室检查结果无助于区分急性阑尾炎的诊断。在阑尾的组织病理学检查中,阑尾壁急性炎症的表现可能不明确。对于组织病理学检查正常的患者,应进行寄生虫筛查,并在阑尾切除术后开始抗寄生虫治疗。

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