Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis/College of Veterinary Medicine, Jilin University, Changchun, 130000, China.
Affiliated Zhongshan Hospital of Dalian University, Dalian, 116000, China.
BMC Infect Dis. 2019 Nov 29;19(1):1014. doi: 10.1186/s12879-019-4644-5.
Clonorchiasis, caused by Clonorchis sinensis (C. sinensis) infection, is a serious food-borne zoonotic disease that is often asymptomatic or shows only mild symptoms, which leads to delayed treatment and chronic clonorchiasis and results in various complications, such as cholelithiasis, cholangitis, cholecystitis and cholangiocarcinoma. However, acute shock caused by C. sinensis infection has not been reported. Here, for the first time, we describe a fatal case of acute shock caused by C. sinensis infection.
A patient with a history of eating raw or undercooked freshwater fish was hospitalized with acute shock caused by severe abdominal pain. Physical examination suggested acute abdomen with severe abdominal pain and rigidity. Computed tomography (CT) detection indicated acute cholecystitis and cholelithiasis. After cholecystectomy, several liver flukes were found in the drainage tube. Furthermore, morphological analysis and polymerase chain reaction (PCR) identified the pathogen as C. sinensis. The liver gradually restored normal function after anthelmintic therapy with praziquantel.
In this fatal case, C. sinensis infection was the cause of acute shock, which is rarely found in the clinic environment. This report aims to increase awareness of the hazards and complications related to clonorchiasis. The PCR diagnosis method used in this report might be helpful in reducing the misdiagnosis of clonorchiasis and unnecessary cholecystectomy.
由华支睾吸虫（C. sinensis）感染引起的华支睾吸虫病是一种严重的食源性人畜共患疾病，常无症状或仅有轻度症状，导致治疗延误和慢性华支睾吸虫病，并导致各种并发症，如胆石症、胆管炎、胆囊炎和胆管癌。然而，尚未报道华支睾吸虫感染引起的急性休克。在这里，我们首次描述了一例由华支睾吸虫感染引起的致命性急性休克病例。
一名有食用生的或未煮熟的淡水鱼史的患者因严重腹痛导致急性休克住院。体格检查提示有急性腹痛和腹肌强直的急性腹痛。计算机断层扫描（CT）检测提示急性胆囊炎和胆石症。胆囊切除术后，引流管中发现了几条肝吸虫。此外，形态分析和聚合酶链反应（PCR）鉴定病原体为华支睾吸虫。在使用吡喹酮驱虫治疗后，肝脏逐渐恢复正常功能。
在这个致命病例中，华支睾吸虫感染是导致急性休克的原因，这种情况在临床环境中很少见。本报告旨在提高对华支睾吸虫病相关危害和并发症的认识。本报告中使用的 PCR 诊断方法可能有助于减少华支睾吸虫病的误诊和不必要的胆囊切除术。
