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[一例输入性埃及血吸虫病病例的诊断与治疗]

[Diagnosis and treatment of an imported case of schistosomiasis haematobium].

作者信息

Yan-Rong Li, Han-Guo Xie, Zhu-Yun Chen, Li-Zhen Xiao, Rong-Yan Zhang

机构信息

Fujian Key Laboratory of Zoonosis, Fujian Center for Disease Control and Prevention, Fuzhou 350001, China.

出版信息

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2017 Jan 19;29(1):108-110. doi: 10.16250/j.32.1374.2016240.

Abstract

OBJECTIVE

To report the diagnosis and treatment of an imported case of schistosomiasis haematobium, including the pathological features of the disease and therapeutic efficacy of praziquantel.

METHODS

The data of the patient with schistosomiasis haematobium were collected, and the pathological features of the bladder tissue were observed under a microscope. More-over, the patient was treated with praziquantel, and his urine was collected before and after the treatment. The eggs in the urine were examined by a microscope after sediment and the miracidia were hatched.

RESULTS

The patient once worked in Angola for three months, and after returning home he had the symptoms of intermittent painless terminal hematuresis. It was ineffective after anti-inflammatory treatment in a number of hospitals. There were no sand spots discovered under the cystoscope. However, the inflammatory reaction to parasite with a lot of eosinophils infiltration in the bladder mucosa was found on the pathological sections under a microscope, and the egg structure was observed with individual characteristics. The eggs were detected in the urine and the miracidia were hatched before the praziquantel treatment. The hematuria symptoms disappeared after the praziquantel treatment. The eggs were still detected in the urine 7 days post-treatment, but the miracidium could not be hatched. One month and 6 months post-treatment, the eggs were not detected in the urine.

CONCLUSIONS

The imported cases of schistosomiasis haematobium are often misdiagnosed, and therefore, it is necessary to strength the health education to the workers overseas and also to improve the ability of diagnosis in medical staff. For the case reported in this paper, there are typical structure of eggs and egg-granulomas on the pathological sections of bladder tissues. Praziquantel has satisfactory treatment results.

摘要

目的

报告1例埃及血吸虫病输入病例的诊断与治疗情况,包括疾病的病理特征及吡喹酮的治疗效果。

方法

收集该埃及血吸虫病患者的资料,显微镜下观察膀胱组织的病理特征。此外,给予患者吡喹酮治疗,并收集治疗前后的尿液。尿液经沉淀后显微镜检查虫卵,并孵化毛蚴。

结果

患者曾在安哥拉工作3个月,回国后出现间歇性无痛性终末血尿症状。多家医院抗炎治疗无效。膀胱镜检查未见沙斑。但显微镜下病理切片显示膀胱黏膜对寄生虫有炎症反应,有大量嗜酸性粒细胞浸润,且观察到虫卵结构具有个体特征。吡喹酮治疗前尿液中检出虫卵并孵化出毛蚴。吡喹酮治疗后血尿症状消失。治疗后7天尿液中仍可检出虫卵,但未孵化出毛蚴。治疗后1个月和6个月尿液中未检出虫卵。

结论

埃及血吸虫病输入病例常被误诊,因此,有必要加强对海外务工人员的健康教育,同时提高医务人员的诊断能力。对于本文报道的病例,膀胱组织病理切片有典型的虫卵及虫卵肉芽肿结构。吡喹酮治疗效果满意。

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