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[九州北部最近的三例蛔虫病病例]

[Three recent cases of ascariasis in northern Kyushu].

作者信息

Makiya K, Tsukamoto M, Unoki H, Sujita K, Mori N, Miki T, Yokoyama M

机构信息

Department of Medical Zoology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

出版信息

J UOEH. 1988 Mar 1;10(1):123-32. doi: 10.7888/juoeh.10.123.

Abstract

Ascariasis is considered to be one of the rare infectious diseases in Japan, but recently it has been slightly increasing. This paper reports three ascariasis cases who seemed to be infected recently in the Kitakyushu area, Japan. Case 1: A 59-year-old woman in Kitakyushu City passed a round worm after continuous abdominal pain. The patient was discharged from the hospital because of no further abnormal intestinal symptoms and findings. Case 2: An 85-year-old woman in Nakama City, who suffered from cerebral infarction, vomited a round worm before hospitalization. Many ascarid eggs were detected after admission, and after treatment with pyrantel pamoate (Combantrin) two round worms were passed and egg detection became negative. Case 3: A 77-year-old man in Saikawa Town vomited 3 round worms after gastrectomy due to early gastric cancer. Many unfertilized eggs were also detected from the stool together with hook worm eggs, but no eggs were found after administration of pyrantel pamoate. Morphological examination was made by a scanning electron microscope on the denticles on the dentigerous lip ridges of the worms to differentiate from possible infection with a pig parasite, Ascaris suum. The three cases were diagnosed as ascariasis due to human Ascaris lumbricoides based on the following evidences that the expelled worms had 1) less pointed tips of the denticles and shallower or wider interdenticle notches, and 2) far more denticles of smaller size along the dentigerous ridges, compared with Ascaris suum. The necessity of differentiating pig- from human-ascarids, when considering human infection with Ascaris suum, is discussed.

摘要

蛔虫病在日本被认为是一种罕见的传染病,但最近其发病率略有上升。本文报告了日本北九州市近期似乎感染蛔虫病的3例病例。病例1:北九州市一名59岁女性在持续腹痛后排出一条蛔虫。由于肠道无进一步异常症状和检查结果,患者出院。病例2:中川市一名85岁患有脑梗死的女性在住院前呕吐出一条蛔虫。入院后检测到许多蛔虫卵,用噻嘧啶(驱虫净)治疗后排出两条蛔虫,虫卵检测呈阴性。病例3:佐川町一名77岁男性因早期胃癌行胃切除术后呕吐出3条蛔虫。粪便中还检测到许多未受精的虫卵以及钩虫卵,但服用噻嘧啶后未发现虫卵。通过扫描电子显微镜对虫体具齿唇嵴上的小齿进行形态学检查,以与可能感染猪寄生虫猪蛔虫相鉴别。根据以下证据,这3例病例被诊断为人蛔虫引起的蛔虫病:1)排出的虫体小齿尖端较钝,齿间凹较浅或较宽;2)与猪蛔虫相比,沿具齿嵴的小齿数量更多且尺寸更小。本文还讨论了在考虑人类感染猪蛔虫时区分猪蛔虫和人蛔虫的必要性。

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