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合并感染病例报告:在一例临床症状不明显的华支睾吸虫感染者中,通过联合诊断工具确诊感染有猪带绦虫。

A co-infection case report of Taenia saginata in a patient with subclinical clonorchiasis confirmed by the combination of diagnostic tools.

机构信息

Department of Laboratory Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.

Department of Parasitology and Tropical Medicine, Chonnam National University Medical School, 264, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea.

出版信息

BMC Infect Dis. 2019 Feb 6;19(1):115. doi: 10.1186/s12879-019-3758-0.

Abstract

BACKGROUND

Clonorchiasis is the common parasitic infection in the general population of the Republic of Korea, however, taeniasis is scarcely reported recently. Here, we describe a case of co-infection with the cestode T. saginata in a patient with subclinical clonorchiasis diagnosed by a combination of diagnostic tools in Korea.

CASE PRESENTATION

A 56-year-old man visited the hospital having passed proglottids in his stool for the past two months and brought a stool sample with segments to our hospital. He had no abdominal symptoms, such as nausea, vomiting, abdominal pain, diarrhea, or constipation. He used to consume raw beef and fish frequently. We could not find evidence of gravid proglottids which contain fully developed uteri filled with ova or branched uterine structures, within the submitted sample. To identify the tapeworm species, we carried out molecular analyses on the proglottids. The cox1 and ef1a sequences had a 100% match with those of T. saginata and differed from the sequences of the other Taenia species. Upon examination of stool samples fixed by formalin-ether concentration method, no Taenia species ova were observed in 10 slides. Instead, C. sinensis ova were observed, despite the level of IgG specific to C. sinensis being within the normal range. The patient was treated with praziquantel (25 mg/kg, three times a day) for 3 days, and subsequently C. sinensis ova were not found in his stool.

CONCLUSION

Our case indicates that a combination of morphological, serological, and molecular diagnostic tools should be used for the accurate diagnosis of subclinical parasitic infections.

摘要

背景

在大韩民国的普通人群中,华支睾吸虫病是常见的寄生虫感染,但最近绦虫病的报道很少。在这里,我们描述了一例在韩国使用多种诊断工具联合诊断为亚临床华支睾吸虫病的患者同时感染带绦虫的病例。

病例介绍

一名 56 岁男性因过去两个月来粪便中有节片而就诊,并将带有节片的粪便样本带到我们医院。他没有恶心、呕吐、腹痛、腹泻或便秘等腹部症状。他过去经常食用生牛肉和生鱼片。我们在提交的样本中未发现含有完全发育的子宫并充满卵子或分支子宫结构的孕节,这是有绦虫感染的证据。为了确定绦虫的种类,我们对节片进行了分子分析。cox1 和 ef1a 序列与牛带绦虫的序列完全匹配,与其他带绦虫物种的序列不同。在用福尔马林乙醚浓缩法固定的粪便样本检查中,在 10 张载玻片上均未观察到带绦虫卵。相反,观察到了华支睾吸虫卵,尽管针对华支睾吸虫的 IgG 特异性处于正常范围内。患者接受了吡喹酮(25mg/kg,每日 3 次)治疗 3 天,随后在他的粪便中未发现华支睾吸虫卵。

结论

我们的病例表明,应使用形态学、血清学和分子诊断工具的组合来准确诊断亚临床寄生虫感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/751d/6364428/8df06b038e99/12879_2019_3758_Fig1_HTML.jpg

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