背景:肺吸虫病是一种典型的食源性人畜共患病。寄主通过摄入生的或未煮熟的小龙虾和螃蟹获得并殖吸虫感染。该病的临床表现多种多样,它经常被误诊或漏诊。肺吸虫病的诊断应综合考虑。吡喹酮是治疗的首选,和阿苯达唑可以在严重的情况下与重复疗程联合使用。
方法:我们报告1例误诊为脓肿的肝并吸虫病。患者出现疲劳和食欲差2个月,并在当地医院被诊断为肝脓肿。六个月后,患者因反复腹痛到我院就诊,根据流行病学史诊断为肝并吸虫病,临床表现,和实验室发现。他接受吡喹酮(25mg/kg)治疗,每天3次,共3天。治疗后症状仍然存在。他接受了口服吡喹酮和阿苯达唑的治疗。随访提示治疗有效,症状改善。
结论:阿苯达唑和吡喹酮联合应用可提高对吸虫病的疗效。
BACKGROUND: Paragonimiasis is a typical food-borne zoonotic disease. Hosts acquire Paragonimus infection through the ingestion of raw or undercooked crayfish and crab. The clinical manifestations of the disease are varied, and it is often misdiagnosed or missed. The diagnosis of paragonimiasis should be considered comprehensively.
Praziquantel is the first choice for treatment, and albendazole can be used in combination with repeated courses in severe cases.
METHODS: We report a
case of liver paragonimiasis that was misdiagnosed as an abscess. The patient presented with fatigue and poor appetite for 2 months, and was diagnosed with liver abscess in the local hospital. After 6 months, the patient visited our hospital because of recurrent abdominal pain and was diagnosed with liver paragonimiasis based on epidemiological history, clinical presentations, and laboratory findings. He was treated with
praziquantel (25 mg/kg) three times a day for 3 days; however, the symptoms still presented after treatment. He was treated with oral
praziquantel and albendazole for one further course. Follow-up suggested that the treatment was effective and the symptoms improved.
CONCLUSIONS: The combination of albendazole and
praziquantel may improve the therapeutic efficacy of paragonimiasis.