中国寄生虫学与寄生虫病杂志 ›› 2025, Vol. 43 ›› Issue (4): 600-602.doi: 10.12140/j.issn.1000-7423.2025.04.024

• 病例报告 • 上一篇    

输入性肺部异盘并殖吸虫病1例

张明芳1(), 计元昊1, 谷生丽2, 蒯荟芬1, 全斌1, 侯为顺1, 杨进孙1,*()()   

  1. 1 皖南医学院第一附属医院(弋矶山医院)感染性疾病科安徽 芜湖 241001
    2 皖南医学院人体寄生虫学教研室安徽 芜湖 241001
  • 收稿日期:2025-05-16 修回日期:2025-07-21 出版日期:2025-08-30 发布日期:2025-10-09
  • 通讯作者: 杨进孙(ORCID:0000-0001-6285-5504),男,硕士,主任医师,从事感染性疾病诊疗及教学工作。E-mail:yangjinsun999999@163.com
  • 作者简介:张明芳,女,学士,主管护师,从事感染性疾病患者护理。E-mail:449106647@qq.com
  • 基金资助:
    安徽省科技厅重点研究与开发计划项目科技惠民专项(2022e07020083);安徽省芜湖市华佗计划卫生优秀人才项目

An imported case of pulmonary paragonimiasis heterotremus

ZHANG Mingfang1(), JI Yuanhao1, GU Shengli2, KUAI Huifen1, QUAN Bin1, HOU Weishun1, YANG Jinsun1,*()()   

  1. 1 Department of Infectious diseases of the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu 241001, Anhui, China
    2 Department of Human Parasitology, Wannan Medical College, Wuhu 241001, Anhui, China
  • Received:2025-05-16 Revised:2025-07-21 Online:2025-08-30 Published:2025-10-09
  • Contact: E-mail: yangjinsun999999@163.com
  • Supported by:
    Anhui Provincial Key Research and Development Program-Science and Technology for People’s Livelihood Special Project(2022e07020083);Wuhu “HUA Tuo Plan” Outstanding Health Talent Program

摘要:

患者,女,27岁,老挝人,有生食溪蟹史,近半年定居于安徽省芜湖市。2025年4月22日因反复咳嗽、咳痰1年就诊于皖南医学院第一附属医院。患者胸部CT示两肺感染性病变伴多发空洞形成、囊腔病变及两侧胸腔少量积液,血常规示嗜酸粒细胞绝对数(1.2 × 109/L)和百分比(12.9%)均升高。取患者肺泡灌洗液送宏基因组二代测序(mNGS),检出异盘并殖吸虫序列数446条;取患者痰液行镜检,找到虫卵,明确诊断为肺部异盘并殖吸虫病。给予患者吡喹酮(口服,1 g/次,3次/d,连续3 d)抗寄生虫治疗,同时给予止咳化痰护理,患者咳嗽症状较前明显改善。15 d后复查嗜酸粒细胞比例3.4%。异盘并殖吸虫病国内报道甚少。此病例提示医务人员在面对常规治疗无效的慢性咳嗽患者时应考虑并殖吸虫病等寄生虫病的可能。

关键词: 异盘并殖吸虫病, 输入性病例, 诊断与治疗, 护理, 肺部病变

Abstract:

A 27-year-old female patient from Laos, with a history of consuming raw freshwater crabs, had been residing in Wuhu City, Anhui Province for the past six months. On April 22, 2025, she presented to the First Affiliated Hospital of Wannan Medical College with a one-year history of recurrent cough and expectoration. Her chest CT revealed infectious lesions in both lungs with multiple cavities, cystic changes, and a small amount of pleural effusion on both sides. The blood routine test showed elevated absolute eosinophil count (1.2 × 109/L) and percentage (12.9%). Metagenomic next-generation sequencing (mNGS) performed on the patient’s bronchoalveolar lavage fluid detected 446 sequences of Paragonimus heterotremus. Eggs were identified upon microscopic examination of the patient’s sputum, leading to a definitive diagnosis of pulmonary P. heterotremus infection. The patient was treated with praziquantel (orally, 1 g per dose, three times daily for three consecutive days) as an antiparasitic therapy, along with cough-relieving and expectorant care. Her cough symptoms significantly improved compared to before, and follow-up examination revealed a reduction in the eosinophil percentage to 3.4%. Reports of P. heterotremus infection are rare in China. This case suggests that medical personnel should consider the possibility of parasitic diseases such as paragonimiasis when encountering patients with chronic cough that does not respond to conventional treatment.

Key words: Paragonimiasis heterotremus, Imported case, Diagnosis and treatment, Nursing care, Pulmonary lesions

中图分类号: