Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China.
Department of Laboratory, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China.
Int J Infect Dis. 2023 Oct;135:8-11. doi: 10.1016/j.ijid.2023.07.013. Epub 2023 Jul 26.
Pleural effusion caused by lung fluke is a rare etiology of exudative pleural effusion (EPE), which is often misdiagnosed or delayed. We aim to summarize the diagnosis and treatment course of EPE caused by lung fluke infection and put forward a practical diagnosis approach.
We retrospectively analyzed the diagnosis and treatment of 14 cases of EPE caused by lung fluke infection diagnosed by enzyme-linked immunosorbent assay of serum antibodies or egg detection.
All patients (100%) with an absolute count of eosinophils in peripheral blood exceeded 0.5 × 10/l, and 10 patients (71.4%) had a history of special ingestion. Eosinophilic PE occurred in 11 patients (78.6%), pleural biopsy of medical thoracoscopic demonstrated eosinophils infiltration in nine patients (64.3%), and parasite eggs in one patient. All patients showed positive intradermal tests for Paragonimus-specific antigens and enzyme-linked immunosorbent assay of serum antibodies to Paragonimus.
For patients with unexplained PE, lung fluke infection should be highly suspected when pleural fluid or pleural biopsy shows eosinophilic PE or eosinophils infiltration, especially for patients with certain diet history.
由肺吸虫引起的胸腔积液是渗出性胸腔积液（EPE）的罕见病因，常被误诊或延误诊断。我们旨在总结肺吸虫感染引起的 EPE 的诊断和治疗过程，并提出一种实用的诊断方法。
我们回顾性分析了 14 例通过血清抗体酶联免疫吸附试验或卵检测诊断为肺吸虫感染引起的 EPE 的诊断和治疗。
所有患者（100%）外周血嗜酸性粒细胞绝对计数均超过 0.5×10/L，且 10 例（71.4%）有特殊摄入史。11 例（78.6%）发生嗜酸性胸腔积液，9 例（64.3%）经胸腔镜活检显示嗜酸性粒细胞浸润，1 例患者有寄生虫卵。所有患者对并殖吸虫特异性抗原的皮内试验和血清抗体酶联免疫吸附试验均呈阳性。
对于不明原因的胸腔积液患者，如果胸腔积液或胸膜活检显示嗜酸性胸腔积液或嗜酸性粒细胞浸润，尤其是有特定饮食史的患者，应高度怀疑肺吸虫感染。
