Huang Yi, Yang Xiaotao, Zhu Ying, Bai Houxi, Jiao Feng, Jin Haifeng, Chen Houyu, Guo Yan, Cui Penghao, Wang Yanchun, Luo Yonghan
Second Department of Infectious Disease, Kunming Children's Hospital, Kunming, Yunnan, 650000, China.
Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.
BMC Infect Dis. 2025 Mar 24;25(1):397. doi: 10.1186/s12879-025-10776-y.
This study aims to analyze the clinical characteristics of clinically diagnosed paragonimiasis in children in Yunnan Province to enhance awareness, reduce misdiagnosis and missed diagnoses, and provide guidance for the clinical management of the disease.
Clinical data from 213 pediatric patients clinically diagnosed with paragonimiasis between 2014 and April 2024 were collected and retrospectively analyzed, focusing on clinical symptoms, laboratory findings, imaging changes, and treatment approaches.
Among the 213 cases, the majority were male (157 cases, 73.7%), with Han ethnicity being the most prevalent (161 cases, 75.6%), and the average age was 7.2 years. The majority of cases originated from Zhaotong City, Yunnan Province (159/213, 74.6%), particularly from Zhenxiong County (90/159, 56.6%), Yiliang County (31/159, 19.5%), and Daguan County (24/159, 15.1%). A clear epidemiological exposure history was present in 177 cases (83.1%), including the consumption of raw water, crayfish, and stream crabs. The most common clinical subtypes were complex (115 cases, 54.0%) and thoracic-pulmonary (83 cases, 39.0%). The three most prevalent clinical manifestations included cough (98 cases, 48.0%), fever (75 cases, 35.2%), and abdominal pain (63 cases, 29.6%). Elevated eosinophil levels were noted in 195 cases (91.5%). Compared to the thoracic-pulmonary subtype, the complex subtype exhibited higher proportions of Han ethnicity, Zhaotong origin, White cell count, hemoglobin levels, and length of hospitalization. All children received oral praziquantel treatment, averaging 2.6 treatment courses, with 121 cases (56.8%) also receiving glucocorticoid therapy, and 45 cases (21.1%) undergoing surgical intervention. Except for five thoracic-pulmonary subtype patients who sought surgery at external facilities, all other patients were discharged after clinical improvement. Follow-up indicated that 143 cases (67.1%) attended regular check-ups, with no residual complications.
The clinical manifestations of clinically diagnosed paragonimiasis are diverse. In addition to immunological examinations and elevated eosinophil counts, an epidemiological history (including residence in endemic areas and consumption of raw water or crayfish) is crucial for diagnosis. After treatment primarily with praziquantel, the prognosis for the majority of patients is favorable.
Not applicable.
本研究旨在分析云南省临床诊断儿童肺吸虫病的临床特征，以提高认识，减少误诊和漏诊，并为该病的临床管理提供指导。
收集2014年至2024年4月间临床诊断为肺吸虫病的213例儿科患者的临床资料，并进行回顾性分析，重点关注临床症状、实验室检查结果、影像学变化及治疗方法。
213例病例中，男性居多（157例，73.7%），汉族最为常见（161例，75.6%），平均年龄为7.2岁。大多数病例来自云南省昭通市（159/213，74.6%），尤其是镇雄县（90/159，56.6%）、彝良县（31/159，19.5%）和大关县（24/159，15.1%）。177例（83.1%）有明确的流行病学暴露史，包括饮用生水、食用小龙虾和溪蟹。最常见的临床亚型为混合型（115例，54.0%）和胸肺型（83例，39.0%）。三种最常见的临床表现包括咳嗽（98例，48.0%）、发热（75例，35.2%）和腹痛（63例，29.6%）。195例（91.5%）嗜酸性粒细胞水平升高。与胸肺型亚型相比，混合型亚型汉族、昭通籍贯、白细胞计数、血红蛋白水平及住院时间的比例更高。所有儿童均接受口服吡喹酮治疗，平均治疗疗程为2.6个，121例（56.8%）还接受了糖皮质激素治疗，45例（21.1%）接受了手术干预。除5例胸肺型亚型患者在外院寻求手术治疗外，所有其他患者临床症状改善后出院。随访表明，143例（67.1%）进行了定期检查，无残留并发症。
临床诊断的肺吸虫病临床表现多样。除免疫检查和嗜酸性粒细胞计数升高外，流行病学史（包括居住在流行地区及饮用生水或食用小龙虾）对诊断至关重要。主要用吡喹酮治疗后，大多数患者预后良好。
不适用。
