儿童并殖吸虫复杂性感染1例  

A child case of complicated Paragonimus infection

作　　者：蔡泽政 杨萍 廖倩倩 CAI Zezheng;YANG Ping;LIAO Qianqian(Department of Pharmacy,People’s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture,Kaili 556000,Guizhou,China;Department of paediatrics,People’s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture,Kaili 556000,Guizhou,China;Department of Pharmacy,Guilin Municipal People’s Hospital,Guilin 541002,Guangxi,China)

机构地区：[1]黔东南苗族侗族自治州人民医院药剂科,贵州凯里556000 [2]黔东南苗族侗族自治州人民医院儿科,贵州凯里556000 [3]桂林市人民医院药学部,广西桂林541002

出　　处：《中国寄生虫学与寄生虫病杂志》2024年第6期813-816,共4页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-C20231578)。

摘　　要：患儿,男,13岁,学生,贵州省剑河县人,因“反复咳嗽20余天”于2023年9月15日就诊于贵州省黔东南州人民医院。2023年8月26日,曾于外院诊断“胸腔积液、社区获得性肺炎”并接受胸腔积液引流及药物治疗后好转。入院后的胸部CT提示仍有少量胸腔积液,查体见腹部脐周有一皮下包块伴皮肤瘙痒,实验室检查示嗜酸粒细胞计数增多(2.28×10^(9)/L),嗜酸粒细胞百分比增加(20.1%),血清总IgE抗体升高(1 101.77 IU/ml),并殖吸虫IgG抗体、华支睾吸虫IgG抗体、裂头蚴IgG抗体均阳性。流行病学调查结果显示患儿有进食蛇肉史及直饮生水史。故诊断为寄生虫感染,并殖吸虫感染可能性大。给予患儿吡喹酮片口服治疗(1.2 g/次,3次/d),2个疗程(5 d+3 d)后,患儿咳嗽、脐周皮下包块、皮肤瘙痒明显缓解,嗜酸粒细胞计数降至正常,于2023年9月26日出院。4个月后复查胸腔仍有少许包裹性胸腔积液伴轻度胸膜增厚。继续随访至10个月后胸腔积液消失。A 13-year-old boy,a student from Jianhe County,Guizhou Province,was admitted to the People’s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture on September 15,2023,due to“repeated coughing for more than 20 days”.On August 26,2023,he was diagnosed with"pleural effusion and community-acquired pneumonia"at an external hospital and received pleural effusion drainage and medication,which improved his condition.The chest CT scan showed a small amount of pleural effusion.Physical examination revealed a subcutaneous mass around the navel with skin itching.Laboratory tests revealed an elevated eosinophil count(2.28×10^(9)/L),eosinophil percentage(20.1%),and serum total IgE antibodies(1101.77 IU/ml).IgG antibodies against Paragonimus,Clonorchis sinensis,and Sparganum were all positive.The epidemiological investigation results showed that the child had a history of eating snake meat and drinking unboiled water.Therefore,a diagnosis of parasitic infection with a high possibility of Paragonimus infection was made.After two courses of oral praziquantel treatment(1.2 g,three times daily,for 5 days and then 3 days),the child’s cough,subcutaneous mass around the navel,and skin itching were significantly relieved,and the eosinophil count returned to normal.He was discharged on September 26,2023.After 4 months,a follow-up showed slight encapsulated pleural effusion with mild pleural thickening.The pleural effusion resolved after 10 months of follow-up.

关 键 词：并殖吸虫 华支睾吸虫 裂头蚴 胸腔积液 皮下包块 儿童 

分 类 号：R532.2[医药卫生—内科学]