病例分享|外出务工人员感染血吸虫病1例

2019-06-11 血寄防微信团队 江苏寄生虫病防治

2010年8月10~19日患者感觉全身不适伴有发热等症状,在当地卫生院当作感冒治疗,不见好转,并且病情继续加重,患者于8月19日转入县人民医院住院治疗,住院11天,期间高烧一直不退,于8月30日转至武汉同济医院进行治疗。

病例

日本血吸虫



图为小鼠感染日本血吸虫后各个时期肝脏HE染色图片(×200)A、B、C、D、E 分别为对照组、感染日本血吸虫尾蚴 6周、8周、10周、12周。

个人信息

年龄:41岁
性别:男
住址:崇阳县沙坪镇
病例时间:2010年(以病人首次就诊时间为准)

病人症状

2010年8月10~19日患者感觉全身不适伴有发热等症状,在当地卫生院当作感冒治疗,不见好转,并且病情继续加重,患者于8月19日转入县人民医院住院治疗,住院11天,期间高烧一直不退,于8月30日转至武汉同济医院进行治疗。


日本血吸虫



患者通过血清免疫学检查、孵化集卵涂片检查均为阳性,确诊为急性血吸虫病。通过询问接触疫水情况,了解到一同到江西打工的约有60~70人。

病例排查

对2009年10月至2010年7月在江西省九江市都昌县务工的农民工72人进行了调查,通过血检查出阳性5人,粪检阳性4人,最终确诊5人为急性血吸虫病。

病例分析

患者既往身体均健康,无血吸虫病病史,2009 年10月至2010年7月均在江西省九江市都昌县务工,江西省九江市都昌县属血吸虫病疫区。均有接触疫水史,无任何防护措施,流行病学史明显。



崇阳县无本地血吸虫病病史,也未发现钉螺孳生,故为非疫区。然该县是一个劳务输出大县,随着经济的改革,流动人口的增加,外出务工人员的文化水平相对较低,防护意识淡薄,成为传染病的高危人群,应引起各有关部门的重视。



血吸虫病是由于接触含有钉螺的疫水而感染,该病潜伏期一般为40d,以高热、肝脏肿大伴压痛、嗜酸性粒细胞增多,腹痛、腹泻等为主要症状。



因该县血吸虫病例较少,医务人员接触较少,临床经验不足,容易造成误诊、漏诊等现象,所以加强专业人员培训,使之掌握血吸虫诊断标准,及时发现患者,以保证患者就诊的及时性、准确性,从而有效控制疫情。

知识拓展

血吸虫也称裂体吸虫,寄生人体的血吸虫主要有6种:日本血吸虫、埃及血吸虫、曼氏血吸虫、间插血吸虫、湄公血吸虫和马来血吸虫。此外,尚有在动物寄生的血吸虫偶尔寄生人体的病例。



流行于我国的血吸虫病由日本血吸虫引起,成虫雌雄异体。雄虫乳白色,前端有发达的口吸盘和腹吸盘,腹吸盘以下,虫体向两侧延展,并略向腹面卷曲,形成抱雌沟,故外观呈圆筒状。雌虫前细后粗,形似线虫,腹吸盘大于口吸盘。人的皮肤、黏膜接触有血吸虫尾蚴的疫水而感染,成虫寄生于门静脉系统,主要致病因素是含毛蚴的虫卵引起的肉芽肿性结节,多位于结肠和肝脏。

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    2019-12-08 wxl882001

    了解一下

    0

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    2019-10-21 wxl882001

    了解一下

    0

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    2019-08-22 wxl882001

    了解一下

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=376711, encodeId=8c5a3e67115c, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Dec 08 21:45:13 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374194, encodeId=b30b3e419447, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Oct 21 22:08:22 CST 2019, time=2019-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371670, encodeId=5c0c3e16706e, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Thu Aug 22 21:41:36 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369659, encodeId=423736965965, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 14 17:04:59 CST 2019, time=2019-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=367804, encodeId=d65e36e80475, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat Jun 15 20:59:16 CST 2019, time=2019-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428870, encodeId=7ae714288e01b, content=<a href='/topic/show?id=ce5a8898902' target=_blank style='color:#2F92EE;'>#血吸虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88989, encryptionId=ce5a8898902, topicName=血吸虫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38144138896, createdName=ylz8404, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1620979, encodeId=749d16209e9ce, content=<a href='/topic/show?id=93f3889917c' target=_blank style='color:#2F92EE;'>#血吸虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88991, encryptionId=93f3889917c, topicName=血吸虫病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a0a20182777, createdName=bugit, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=)]
    2019-07-14 wxl882001

    了解一下

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=376711, encodeId=8c5a3e67115c, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Dec 08 21:45:13 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374194, encodeId=b30b3e419447, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Oct 21 22:08:22 CST 2019, time=2019-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371670, encodeId=5c0c3e16706e, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Thu Aug 22 21:41:36 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369659, encodeId=423736965965, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 14 17:04:59 CST 2019, time=2019-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=367804, encodeId=d65e36e80475, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat Jun 15 20:59:16 CST 2019, time=2019-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428870, encodeId=7ae714288e01b, content=<a href='/topic/show?id=ce5a8898902' target=_blank style='color:#2F92EE;'>#血吸虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88989, encryptionId=ce5a8898902, topicName=血吸虫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38144138896, createdName=ylz8404, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1620979, encodeId=749d16209e9ce, content=<a href='/topic/show?id=93f3889917c' target=_blank style='color:#2F92EE;'>#血吸虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88991, encryptionId=93f3889917c, topicName=血吸虫病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a0a20182777, createdName=bugit, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=)]
    2019-06-15 wxl882001

    了解一下

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=376711, encodeId=8c5a3e67115c, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Dec 08 21:45:13 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374194, encodeId=b30b3e419447, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Oct 21 22:08:22 CST 2019, time=2019-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371670, encodeId=5c0c3e16706e, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Thu Aug 22 21:41:36 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369659, encodeId=423736965965, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 14 17:04:59 CST 2019, time=2019-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=367804, encodeId=d65e36e80475, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat Jun 15 20:59:16 CST 2019, time=2019-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428870, encodeId=7ae714288e01b, content=<a href='/topic/show?id=ce5a8898902' target=_blank style='color:#2F92EE;'>#血吸虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88989, encryptionId=ce5a8898902, topicName=血吸虫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38144138896, createdName=ylz8404, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1620979, encodeId=749d16209e9ce, content=<a href='/topic/show?id=93f3889917c' target=_blank style='color:#2F92EE;'>#血吸虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88991, encryptionId=93f3889917c, topicName=血吸虫病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a0a20182777, createdName=bugit, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=)]
    2019-06-13 ylz8404
  7. [GetPortalCommentsPageByObjectIdResponse(id=376711, encodeId=8c5a3e67115c, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Dec 08 21:45:13 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374194, encodeId=b30b3e419447, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Oct 21 22:08:22 CST 2019, time=2019-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371670, encodeId=5c0c3e16706e, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Thu Aug 22 21:41:36 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369659, encodeId=423736965965, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 14 17:04:59 CST 2019, time=2019-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=367804, encodeId=d65e36e80475, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat Jun 15 20:59:16 CST 2019, time=2019-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428870, encodeId=7ae714288e01b, content=<a href='/topic/show?id=ce5a8898902' target=_blank style='color:#2F92EE;'>#血吸虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88989, encryptionId=ce5a8898902, topicName=血吸虫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38144138896, createdName=ylz8404, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1620979, encodeId=749d16209e9ce, content=<a href='/topic/show?id=93f3889917c' target=_blank style='color:#2F92EE;'>#血吸虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88991, encryptionId=93f3889917c, topicName=血吸虫病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a0a20182777, createdName=bugit, createdTime=Thu Jun 13 06:53:00 CST 2019, time=2019-06-13, status=1, ipAttribution=)]