Paragonimiasis in Sichuan
Introduction
Introduction to Paragonimosis in Sichuan Paragonimusisskrjabini, also known as paragonimus in Sichuan, is caused by parasitic humans of Paragonimus krjabini, whose aphids migrate around the body, causing inflammation and necrosis of subcutaneous tissues and organs. , allergic, cystic lesions, the clinical features are mainly the downstream of the skin cystic nodules. basic knowledge The proportion of illness: 0.0002% - 0.0003% Susceptible people: no special people Mode of infection: fecal mouth spread Complications: emphysema
Cause
The cause of paragonimiasis in Sichuan
Environmental factors (55%):
Personal hygiene is unclean or does not pay attention to public health, and is directly transmitted through contact with eggs or adults.
Dietary factors (45%):
Food in the diet is contaminated, resulting in the consumption of eggs. The first intermediate host is mainly crab, and the final host is civet, dog, cat, leopard, etc. Monkey, dog, rat and rabbit have been successfully infected, and human is an abnormal host.
The adult worms of the larvae of Schistosoma japonicum are long and narrow, with sharp ends at both ends, slightly fusiform, and the size (11 ~ 18.5) mm × (3.5 ~ 6) mm, the skin spines are mainly solitary, chisel-shaped, abdominal suction plate slightly Larger than the mouth suction cup, located in the front 1/3 of the body, the ovary branches are slender, located behind the abdominal suction cup, the testicles are branched, located in the back 1/3 of the body, the eggs are oval, slightly asymmetrical, different in size, egg shell It is uneven in thickness and contains 1 egg cell and 9 to 12 yolk cells.
Pathogenesis
Because the human body is not a suitable host for paragonimiasis in Sichuan, it cannot mature in the body, and its worms swim around to find suitable parasitic sites, causing damage and lesions of subcutaneous tissues, lungs, brain, liver and other organs. The main lesions are flaky or banded hemorrhagic necrosis, tunnels formed by worms and acidic granulocyte abscesses, sometimes found in the lesions, but no eggs have been found.
Prevention
Sichuan Paragonimosis Prevention
The key to preventing this disease is to eliminate raw habits such as raw food, half-life crabs, sputum and drinking raw water, thoroughly treat patients and sick animals, kill the main pests that are harmful to humans, change spitting and bowel habits, and raise Domestic ducks or breeding squid to eliminate the first intermediate host can cut off the relay route.
Complication
Parallel worm complications in Sichuan Complications emphysema
Can be complicated by bronchitis, asthma, emphysema and liquid pneumothorax, severe cases may appear paraplegia.
Symptom
Symptoms of Paragonimiasis in Sichuan Common Symptoms Eosinophilic granuloma in the liver, meningeal irritation, abscess, granulomatous pleural effusion, pleural effusion, liver function abnormality, subcutaneous nodular constrictive pericarditis cyst
Most of the incubation period is 3 to 6 months, with aphid migration as the main clinical manifestation.
Other clinical manifestations
Liver damage
The early lesions of liver tissue are flaky or banded hemorrhagic necrosis, which can form eosinophilic abscess. The center is a large number of eosinophils, necrotic tissue debris or Charcot-Leidden crystals. Collagen fibers can be seen in the complete abscess area of abscess. Hyperplasia, individual parts can form pseudolobules, so some patients may have liver swelling and pain in the clinic, and abnormal liver function.
2. Subcutaneous downstream nodules
Subcutaneous mass is more common in the chest and abdomen, the initial boundary is unclear, edema-like, gradually shrinking later, the boundary is clear, most of the diameter is 3.4cm, occasionally 10cm, local pain and itching, single or multiple aggregation, with migration One after another.
3. Pulmonary symptoms
The lesions in the lungs are basically the same as those in the liver. The patient may have a cough, a small amount of fresh red blood in the sputum, and the pleural effusion is yellow or bloody in the pleural effusion, and contains a large amount of eosinophils.
4. Other symptoms
When the mites migrate to the brain, headache, vomiting, epilepsy, meningeal irritation, subarachnoid hemorrhage, but less common than the paragonimiasis are common; most of them are accompanied by brain symptoms such as optic disc edema, hyperemia, unilateral Eyeballs are prominent, eyelids are incompletely closed, vision loss, sag, diplopia and other symptoms, children may have paragonimiasi pericarditis, often have palpitation, shortness of breath, cough and edema, X-ray, B-ultrasound, CT or ECG can be Prompt pericardial effusion, part of the appearance of constrictive pericarditis.
Examine
Inspection of paragonimiasis in Sichuan
Blood: visible eosinophilia, increased erythrocyte sedimentation rate, but sputum, feces and biopsy can not find eggs.
X-ray chest examination showed a light patchy, hemorrhagic, inflammatory infiltrating shadow, lasting for a short period of time; rare cyst shadow.
Diagnosis
Diagnosis and identification of paragonimiasis in Sichuan
clinical diagnosis
Similar to Wei's paragonimiasis, the clinical manifestations were more common with subcutaneous nodules, and peripheral eosinophils increased significantly.
Experimental diagnosis
(1) Subcutaneous mass biopsy can be confirmed by eosinophilic granuloma and paragonimiasis.
(2) The intradermal test and the complement fixation test of Pneumocystis can be positive.
(3) , feces and subcutaneous mass can not find eggs.
(4) X-ray chest examination showed a light patchy, hemorrhagic, inflammatory infiltrating shadow, lasting for a short period of time; rare cyst shadow.
(5) Monoclonal antibody-antigen spot test (McAb-AST) can detect circulating antigen of Schistosoma japonicum, with high sensitivity and specificity, and can be used for efficacy evaluation.
Differential diagnosis
Mainly differentiated from tuberculosis, tuberculous pleurisy, subcutaneous tumors, identification points of Wei's and Sichuan paragonimiasis.
