广西来宾市1例片形吸虫病诊治及流行病学调查
Diagnosis,treatment,and epidemiological investigation of a case of fasciolosis in Laibin,Guangxi
陆燕 1何名聪 2覃小升 1莫陆芳 1张伟尉 3杨益超 3石云良4
作者信息
- 1. 来宾市兴宾区人民医院检验科,广西来宾 546100
- 2. 来宾市疾病预防控制中心,广西来宾 546199
- 3. 广西壮族自治区疾病预防控制中心,广西南宁 530028
- 4. 广西医科大学基础医学院寄生虫学教研室,广西南宁 530021
- 折叠
摘要
报道广西来宾市1例片形吸虫病诊疗和流行病学调查过程,为片形吸虫病预防控制提供依据.患者因上腹部疼痛到医院就诊,根据患者主要症状、体征、临床表现,经腹部B超、CT检查及粪便水洗沉淀法镜检发现片形吸虫卵,提取虫卵DNA经ITS2基因扩增、测序和比对,与NCBI巨片形吸虫ITS2序列同源性为99.2％,确诊患者为巨片形吸虫病,经三氯苯达唑驱虫治疗后症状消失、粪便复查虫卵阴性.以水洗沉淀法检测患者周边33份人粪便样本和以压片镜检200份小土蜗螺及20份尖膀胱螺检测片形吸虫卵均为阴性;检测患者居住地附近10份水牛粪便,有8份(占80％)检测到片形吸虫卵,ITS2基因扩增、测序证实为巨片形吸虫;收集患者种植并腌制生吃芋檬10份,也未发现片形吸虫囊蚴粘附.结果表明,本次病例是1例偶然的片形吸虫感染病例,患者临床症状缺乏特异性,需结合大便虫卵检查和分子诊断进行确诊.
Abstract
This article reported the diagnosis and treatment of a case of fascioliasis as well as an epidemiological investigation conducted in Laibin City,Guangxi,China.The patient came to the hospital for bellyache.Based on the patient's main symptoms,physical signs,clinical presentation,and laboratory examination(abdominal ultrasound scan and CT),fasciola eggs were detected through the examination of stool specimens using the sedimentation method.Fasciola egg DNA was extracted,and after amplification,sequencing,and comparison of the ITS2 gene,a homology of 99.2％with Fasciola gigantica ITS2 sequences in the NCBI database confirmed the diagnosis of Fasciola gigantica infection.After triclabendazole treatment,the patient's symptoms disappeared,and stool examination yielded negative results for Fasciola eggs.A survey of 33 human fecal samples from the patient's vicinity all tested negative,while examination of 10 samples of water buffalo feces from around the residence found Fasciola eggs in eight samples(80％),confirmed as Fasciola gigantica through ITS2 gene amplification and sequencing;microscopic examination of 200 specimens of Galba pervia and 20 physaacuta revealed no positive findings;Additionally,observation of 10 samples of pickled Colocasia gigantea(a local edible plant)that the patient had cultivated and consumed raw revealed no Fasciola metacercariae attachment.The results indicate that this case was an accidental case of Fasciola infection.Due to the lack of specificity in clinical symptoms,it is necessary to combine stool examination for Fasciola eggs and molecular diagnosis to confirm the condition.
关键词
巨片形吸虫/虫卵/ITS2/三氯苯达唑/流行病学调查Key words
Fasciola gigantica/egg/ITS2/trichlorobenzendazole/epidemiological investigation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据