洛阳市1例华支睾吸虫病误诊误治为弓形虫病的调查报告  

Investigation Report of A Case of Clonorchiasis Sinensis Misdiagnosed asToxoplasmosis in Luoyang City

作　　者：刘英[1] 郭正印[1] 臧珂[2] LIU Ying;GUO Zhengyin;ZANG Ke(Institute of Health Education,Luoyang Center for Disease Control and Prevention,Luoyang 471000,China;Infectious Disease Department,Luoyang Central Hospital,Luoyang 471000,China)

机构地区：[1]洛阳市疾病预防控制中心健康教育所,河南洛阳471000 [2]洛阳市中心医院传染科,河南洛阳471000

出　　处：《河南医学研究》2024年第24期4601-4603,共3页Henan Medical Research

摘　　要：华支睾吸虫病是由华支睾吸虫感染人和动物引起肝胆病变的一种食源性寄生虫病,多由于人和动物生食或半生食淡水鱼肉引起,在洛阳地区较为少见,临床表现以消化系统病变为主。本文报道了1例33岁男性华支睾吸虫病患者,发病前有食用生鱼片的流行病学史,临床症状和体征以腹部不适和肝胆系统损害为主,淋巴结肿大,实验室检查表现为肝功能异常,嗜酸细胞百分比、嗜酸细胞计数升高,C反应蛋白升高。采用肝吸虫抗体检查,但是因和弓形虫病、肺吸虫病存在抗体交叉反应,造成首次住院误诊误治。患者经吡喹酮片治疗后痊愈,出院38 d后复查,各项指标正常。建议对华支睾吸虫病患者采用诊断性治疗,吡喹酮片是治疗华支睾吸虫的特效药。借此病例报道提醒临床医生提高对华支睾吸虫病认识的敏感性,以减少漏诊和误诊。Clonorchiasis sinensis is a food-borne parasitic disease caused by clonorchis sinensis infects humans and animals and causes hepatobiliary diseases.Mostly caused by people and animals eating raw or semi-raw freshwater fish.In the Luoyang region,it is infrequently encountered,with clinical manifestations primarily associated with gastrointestinal disorders.This paper presents a case of a 33 year-old male patient diagnosed with clonorchiasis,who had an epidemiological history of consuming sashimi prior to symptom onset.The clinical manifestations primarily included abdominal discomfort,hepatobiliary system impairment,lymphadenopathy,and laboratory findings indicated abnormal liver function,elevated eosinophil percentage and count,as well as increased levels of C-reactive protein.The patient underwent liver fluke antibody examination,but there was antibody cross-reaction with toxoplasmosis and pneumostomiasis,resulting in misdiagnosis and mistreatment in the first hospitalization.The patient recovered after treatment with praziquantel tablets,and was re-examined 38 days after discharge,all indicators were normal.It is recommended to use diagnostic treatment for clonorchis sinensis.Praziquantel tablet is the effective drug for clonorchis sinensis.This case report reminds clinicians to improve the awareness of clonorchiasis sensitivity in order to reduce missed diagnosis and misdiagnosis.

关 键 词：华支睾吸虫病 临床症状和体征 抗体交叉反应 

分 类 号：R378.3[医药卫生—病原生物学]