Nakamura Itaru, Yagi Kenji, Kumagai Takashi, Ohta Nobuo
Departments of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo, 162-0845, Japan.
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
IDCases. 2017 Oct 20;10:108-109. doi: 10.1016/j.idcr.2017.10.005. eCollection 2017.
The rise in eco-tourism and travel off the beaten track have increased numbers of tourists with schistosomiasis which is seldom seen in developed countries, although this disease is considered a neglected tropical disease especially in poor communities. A Guinean male living in Japan was seen complaining of severe constipation. He was positive for fecal occult blood (FOB) and underwent colonoscopy. Colonoscopy showed petechiae of the rectal mucosa, with pathologic examination of biopsy tissue showing calcified eggs of the genus Schistosoma. Direct examination of eggs in feces and antibody tests of serum confirmed the diagnosis of schistosomiasis. The patient was administered Praziquantel (400 mg/day for 2 days) and FOB and fecal ova tests were negative after treatment. FOB tests have been reported as a useful assessment of morbidities associated with intestinal schistosomiasis. In developed countries, positive FOB result, which is used as a main examination for bowel malignant disease, are not recognized as being due to schistosomiasis. As this tropical disease is rarely present in developed countries, it may be under-diagnosed. Schistosomiasis should be included in the differential diagnosis of patients with positive FOB tests.
生态旅游的兴起以及人们前往人迹罕至之地旅行，使得感染血吸虫病的游客数量增加。血吸虫病在发达国家很少见，尽管这种疾病被视为一种被忽视的热带疾病，尤其在贫困社区。一名居住在日本的几内亚男性因严重便秘前来就诊。他的粪便潜血（FOB）检测呈阳性，并接受了结肠镜检查。结肠镜检查显示直肠黏膜有瘀点，活检组织的病理检查显示有血吸虫属的钙化虫卵。粪便虫卵直接检查和血清抗体检测确诊为血吸虫病。患者接受了吡喹酮治疗（400毫克/天，共2天），治疗后FOB和粪便虫卵检测均为阴性。据报道，FOB检测对于评估肠道血吸虫病相关的发病率很有用。在发达国家，作为肠道恶性疾病主要检查项目的FOB检测呈阳性，并不被认为是由血吸虫病引起的。由于这种热带疾病在发达国家很少出现，可能存在诊断不足的情况。对于FOB检测呈阳性的患者，血吸虫病应纳入鉴别诊断。
