论著

双叶槽绦虫肠道感染患者的临床表现特征分析

  • 李小丽 ,
  • 栗绍刚 ,
  • 吴赵永
展开
  • 首都医科大学附属北京友谊医院北京热带医学研究所,北京 100050
李小丽(1980-),女,博士研究生,副主任医师,从事热带病及寄生虫病的诊治及其病原体的基础研究。E-mail:lixiaoli@ccmu.edu.cn
*吴赵永(1969-),男,本科,主管技师,从事热带病及寄生虫病病原体的检验及研究。E-mail:wzy_l@126.com

收稿日期: 2023-02-01

  修回日期: 2023-04-04

  网络出版日期: 2023-09-06

基金资助

国家自然科学基金(81702018);首都医科大学附属友谊医院启动基金(yyqdkt2018-34)

Clinical characteristics of patients with intestinal Diphyllobothrium tapeworm infection

  • LI Xiaoli ,
  • LI Shaogang ,
  • WU Zhaoyong
Expand
  • Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received date: 2023-02-01

  Revised date: 2023-04-04

  Online published: 2023-09-06

Supported by

National Natural Science Foundation of China(81702018);Research Foundation of Beijing Friendship Hospital, Capital Medical University(yyqdkt2018-34)

摘要

目的 总结并分析双叶槽绦虫肠道感染病例的临床表现及实验室指标变化特征。 方法 收集2009年1月—2022年7月在北京友谊医院确诊的18例双叶槽绦虫感染病例的病历资料,包括性别、年龄、流行病学史(居住地、国外旅居史及饮食习惯)、临床表现、入院期间血常规、肝功能、粪便虫卵检测和虫种鉴定、治疗和预后等,对双叶槽绦虫感染的临床特点进行总结,并分析比较其实验室指标差异。 结果 18例感染病例中男性、女性各9例,平均年龄为(28.88 ± 11.57)岁,年龄最小为8岁,最大为47岁。流行病学调查结果显示,其中12例为北京本地病例,6例来自其他省份;7例有国外旅居史;所有病例均有食生/半生鱼肉或牛肉史。确诊的18例双叶槽绦虫感染病例临床表现为腹痛、腹胀症状6例,头晕2例,肛周瘙痒、体质量下降均未见,无症状10例。炎性指标白细胞、C-反应蛋白及血沉均未见异常,贫血指标红细胞和血红蛋白未见降低,嗜酸粒细胞未见升高。肝功能指标均未见升高。粪检查见双叶槽绦虫虫卵8例,所有病例粪样中均可见到节片。给予中药槟榔-南瓜子疗法进行驱虫治疗,均治愈。 结论 双叶槽绦虫感染病例多无临床症状或轻微的消化道症状,血常规及肝功能检测均未见明显异常,可结合粪检等病原学检查和流行病学调查进行早期诊断。

本文引用格式

李小丽 , 栗绍刚 , 吴赵永 . 双叶槽绦虫肠道感染患者的临床表现特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2023 , 41(4) : 459 -463 . DOI: 10.12140/j.issn.1000-7423.2023.04.010

Abstract

Objective To summarize and analyze the characteristics of clinical manifestation and laboratory indicators of patients with intestinal infection of Diphyllobothrium tapeworm. Methods The medical record, including gender, age, epidemiological history (residence, history of overseas traveling and dietary habits), clinical manifestation, laboratory examinations when admitted (blood routing test, liver function, fecal examination for parasite eggs, and parasite species identification), treatment record and prognosis were collected from 18 diphyllobothriasis cases diagnosed at the Beijing Friendship Hospital, Capital Medical University from January 2009 to July 2022. Information on patients' clinical features and the changes in laboratory findings were summarized and analyzed. Results The 18 cases included 9 male and 9 female respectively, of them the age ranged from 8 to 47 years with an average of (28.88 ± 11.57) years. Epidemiological inquiry indicated that 12 cases were locals from Beijing, while 6 patients were from other provinces, among them 7 patients had overseas traveling history, and all patients had history of consuming raw/undercooked fish meat and beef. The clinical manifestation of the 18 cases were abdominal pain and distension in 6 cases, and dizziness in 2 cases, whereas anal pruritus and body weight loss were not seen, and 10 were asymptomatic. The inflammatory indicator of leukocyte count, C-reactive protein, erythrocyte sedimentation rate, anemia indicator of erythrocyte and hemoglobin, eosinophils count, and liver function showed no abnormal changes. Fecal examination found Diphyllobothrium tapeworm eggs in the samples from 8 cases, and proglottids from all cases. Deworming regime with Chinese medicine areca-pumpkin seed cured all patients. Conclusion Most of the cases infected with Diphyllobothrium tapeworm are asymptomatic or showed only mild gastrointestinal symptoms, with no significant abnormal changes in blood routine test and liver function examination. Early diagnosis could be made by fecal examination etiologically and epidemiological inquiry.

参考文献

[1] Scholz T, Kuchta R, Brabec J. Broad tapeworms (Diphyllobothriidae), parasites of wildlife and humans: recent progress and future challenges[J]. Int J Parasitol Parasites Wildl, 2019, 9:359-369.
[2] Cai YC, Chen SH, Yamasaki H, et al. Four human cases of Diphyllobothrium nihonkaiense (Eucestoda : Diphyllobothriidae) in China with a brief review of Chinese cases[J]. Korean J Parasitol, 2017, 55(3): 319-325.
[3] Qian MB, Li SZ, Zhou XN. Epidemiological status and control of important food-borne parasitic diseases in China[J]. J Trop Dis Parasitol, 2021, 19(5): 241-244. (in Chinese)
  (钱门宝, 李石柱, 周晓农. 我国重要食源性寄生虫病的流行和控制[J]. 热带病与寄生虫学, 2021, 19(5): 241-244.)
[4] Pozio E. How globalization and climate change could affect food-borne parasites[J]. Exp Parasitol, 2020, 208: 107807.
[5] Cong W, Elsheikha HM. Biology, epidemiology, clinical features, diagnosis, and treatment of selected fish-borne parasitic zoonoses[J]. Yale J Biol Med, 2021, 94(2): 297-309.
[6] Byun TJ, Han DS, Ahn SB, et al. Multiple colonic aphthoid ulcers caused by Diphyllobothrium latum infection[J]. Endoscopy, 2009, 41 Suppl 2: E181-182.
[7] Li YR, Li LS, Jiang DW, et al. A case of Diphyllobothrium latum infection after eating raw salmon[J]. Chin J Parasitol Parasit Dis, 2013, 31(6): 494. (in Chinese)
  (李燕榕, 李莉莎, 江典伟, 等. 食生三文鱼感染阔节裂头绦虫1例报告[J]. 中国寄生虫学与寄生虫病杂志, 2013, 31(6): 494.)
[8] Tsuboi M, Hayakawa K, Yamasaki H, et al. Clinical characteristics and epidemiology of intestinal tapeworm infections over the last decade in Tokyo, Japan: a retrospective review[J]. PLoS Negl Trop Dis, 2018, 12(2): e0006297.
[9] Katahira H, Matsuda AT, Maeda S, et al. Diphyllobothrium stemmacephalum (Cestoda : Diphyllobothriidae) found from a harbor porpoise in northern Japan, with comments on a geographical gap with human infection cases in southern Japan[J]. Parasitol Int, 2022, 87: 102487.
[10] Menconi V, Pastorino P, Momo I, et al. Occurrence and spatial distribution of Dibothriocephalus Latus (Cestoda : Diphyllobothriidea) in Lake Iseo (Northern Italy): an update[J]. Int J Environ Res Public Health, 2020, 17(14): 5070.
[11] Kim JH, Lee JH. Images in clinical medicine. Diphyllobothrium latum during colonoscopy[J]. N Engl J Med, 2010, 362(11): e40.
[12] Zhang YG, Qi ZJ, Tao RG. A case of ileum perforation complicated with abdominal abscess caused by Taenia saginata[J]. Chin J Parasitol Parasit Dis, 2020, 38(5): 629-630. (in Chinese)
  (张永国, 祁之俊, 陶荣刚. 牛带绦虫感染致回肠穿孔并发腹腔脓肿1例[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(5): 629-630.)
[13] Mitre E, Klion AD. Eosinophils and helminth infection: protective or pathogenic?[J]. Semin Immunopathol, 2021, 43(3): 363-381.
[14] Jiang JQ, Eedun MT, Bao HE, et al. Association of eosinophils with immune responsesin parasitic infections[J]. Heilongjiang Animal Sci Veter Med, 2016, 495(2): 63-67. (in Chinese)
  (姜建强, 额尔敦木图, 包花尔, 等. 嗜酸性粒细胞与寄生虫感染免疫的相关性[J]. 黑龙江畜牧兽医, 2016, 495(2): 63-67.)
[15] Sharma K, Wijarnpreecha K, Merrell N. Diphyllobothrium latum mimicking subacute appendicitis[J]. Gastroenterol Res, 2018, 11(3): 235-237.
[16] Zhang W, Che F, Tian S, et al. Molecular identification of Diphyllobothrium nihonkaiense from 3 human cases in Heilongjiang Province with a brief literature review in China[J]. Korean J Parasitol, 2015, 53(6): 683-688.
[17] Chen S, Ai L, Zhang Y, et al. Molecular detection of Diphyllobothrium nihonkaiense in humans, China[J]. Emerg Infect Dis, 2014, 20(2): 315-318.
[18] Scholz T, Kuchta R. Fish-borne, zoonotic cestodes (Diphyllobothrium and relatives) in cold climates: a never-ending story of neglected and (re)-emergent parasites[J]. Food Waterborne Parasitol, 2016, 4: 23-38.
[19] An YC, Sung CC, Wang CC, et al. Molecular identification of Diphyllobothrium latum from a pediatric case in Taiwan[J]. Korean J Parasitol, 2017, 55(4): 425-428.
文章导航

/

〈 〉