肝舌形虫病的临床病理观察(附1例报告及文献复习)

Pentastomiasis of the Liver:a Case Report

目的:探讨人类感染舌形虫病的临床病理特征、诊断及鉴别诊断。方法:观察1例舌形虫感染的临床表现,经肝穿刺和石蜡切片观察其形态学变化,粪便检出虫体及鉴定,并结合文献复习其生物学特征。结果:舌形虫病为动物源性人兽共患疾病,蛇、犬等是人类舌形虫病的储存宿主,为主要传染源,传播途径为经口感染。舌形虫主要寄生在人的肝、肠、肺等器官。临床表现为反复腹痛、腹胀等急性感染症状;诊断依据虫体的外表特征及特性,B超、X线及免疫学有助于诊断。组织学表现为急性嗜酸性粒细胞浸润、坏死和舌形虫性肉芽肿形成,并见到未变性或崩解的虫体结构及钙化结节。治疗以中药驱虫为主。结论:舌形虫病的临床表现与其游走性、寄生部位、虫体数量及感染程度有关,根据虫体的形态特征有助于鉴别诊断。

Objective：To study the clinical and pathological characteristics, diagnosis and differential diagnosis in patients infected with pentastoma. Methods：Based on the clinical characteristics of pentastomiasis, the histological morphological method was used to observe the liver biopsy specimen on the paraffin slides. The parasite of pentastoma was also identified under microscope in the fecal specimen, its biological characteristics were reviewed. Results： The source of infection in this patient come from anima. Pentastoma can infect both animals and human brings. The infected animals such as snake and dog etc. are a major source of infection. The present study revealed that the path of infection was through oral route. The parasitic sites are liver, intestine and lungs. The acute infectious of the patient were recurrent abdominal pain and abdominal distention. The diagnosis was made by identification of the morphological characteristics of the parasite, by ultrasound examination, radiograph and immunological essay. In addition, the other histological findings include eosinocyte infiltration, necrosis and parasitic granulation. The bodies of identified parasites without degeneration or collapse and the calcified nodules were observed. The therapy was mainly carried out by Traditional Chinese Medication which kills the parasite. Conclusion： The clinical manifestations of pentastomiasis are related to its migration, parasitic locations, the number of the parasites and the degree of infection. The morphologic characteristics are one of the key points in the differential diagnosis.