1例输入性埃及血吸虫病的诊治  

Diagnosis and treatment of an imported case of schistosomiasis haematobium

作　　者：李燕榕[1] 谢汉国[1] 陈朱云[1] 肖丽贞 张榕燕[1] 

机构地区：[1]福建省疾病预防控制中心,福建省人兽共患病研究重点实验室,福州350001

出　　处：《中国血吸虫病防治杂志》2017年第1期108-110,共3页Chinese Journal of Schistosomiasis Control

基　　金：国家重点研发计划(2016YFC1202001)

摘　　要：目的报告1例输入性埃及血吸虫病病例的诊治经过,并观察其病理特征及吡喹酮治疗效果。方法收集患者病例资料,经膀胱镜取膀胱组织,切片镜检观察其病理特征。此外,对患者采用吡喹酮进行治疗,治疗前后收集尿液,沉淀后镜检虫卵,孵化毛蚴。结果患者在安哥拉务工3个月,回国后出现间歇性无痛性终末血尿症状,经多家医院抗炎治疗无效。膀胱镜下未见沙样斑,病理切片镜下可见大量嗜酸性粒细胞浸润膀胱黏膜的寄生虫性炎性反应,并可见具有个性特征的虫卵结构。治疗前尿液检出虫卵并孵出毛蚴,吡喹酮治疗后血尿症状消失。治后7 d尿液仍能查到虫卵,但不能孵出毛蚴。治疗后1个月和6个月尿液检查均未查及虫卵。结论输入性埃及血吸虫病病例常被误诊,需对境外务工人员加强健康教育并提高诊断能力。本例病理切片具有典型的虫卵结构和虫卵性肉芽肿特征,患者吡喹酮治疗效果满意。Objective To report the diagnosis and treatment of an imported case of schistosomiasis haematobium, including the pathological features of the disease and therapeutic efficacy of praziquantel. Methods The data of the patient with schistoso- miasis haematobium were collected, and the pathological features of the bladder tissue were observed under a microscope. More- over, the patient was treated with praziquantel, and his urine was collected before and after the treatment. The eggs in the urine were examined by a microscope after sediment and the miracidia were hatched. Results The patient once worked in Angola for three months, and after returning home he had the symptoms of intermittent painless terminal hematuresis. It was ineffective af- ter anti-inflammatory treatment in a number of hospitals. There were no sand spots discovered under the cystoscope. However, the inflammatory reaction to parasite with a lot of eosinophils infiltration in the bladder mucosa was found on the pathological sec- tions under a microscope, and the egg structure was observed with individual characteristics. The eggs were detected in the urine and the miracidia were hatched before the praziquantel treatment. The hematuria symptoms disappeared after the praziquantel treatment. The eggs were still detected in the urine 7 days post-treatment, but the miracidium could not be hatched. One month and 6 months post-treatment, the eggs were not detected in the urine. Conclusions The imported cases of schistosomiasis hae- matobium are often misdiagnosed, and therefore, it is necessary to strength the health education to the workers overseas and also to improve the ability of diagnosis in medical staff. For the case reported in this paper, there are typical structure of Schistosoma haematobium eggs and egg-granulomas on the pathological sections of bladder tissues. Praziquantel has satisfactory treatment resuits.

关 键 词：埃及血吸虫病 病理特征 吡喹酮 血吸虫卵 毛蚴 

分 类 号：R532.21[医药卫生—内科学]