曼氏裂头蚴病12例临床特点分析

Analysis of clinical features in 12 patients with Sparganosis mansoni

目的:分析12例曼氏裂头蚴病患者的临床特点,以提高临床医师对该病的认识。方法:收集我院1996年1月至2008年3月曼氏裂头蚴病患者12例,总结其临床表现、流行病学特点及诊断要点等,并结合文献进行分析。结果:12例曼氏裂头蚴病患者临床表现各不相同,分别表现为中枢神经系统症状,头痛、视物旋转等5例;皮下肿块4例;胸痛、咳嗽1例;全身蚁行感1例;局部敷贴青蛙皮肉处溃烂、肿胀1例。所有患者外周血曼氏裂头蚴抗体检查均呈阳性,所有诊断均经病理活检和虫体鉴定证实。12例患者中7例男性,5例女性,男女比例1.4:1,其中9例有常食用蛙肉、蛇肉史。结论:曼氏裂头蚴病临床表现各不相同,为减少误诊、漏诊及延迟诊断,临床实践中要注意掌握该病流行病学资料和行寄生虫抗体检查,必要时作脑部CT、MRI检查,并可进一步作病理活检及虫体鉴定确诊。

Objective To analyze the clinical feature and diagnostic key point of Sparganosis mansoni infection. Methods Twelve patients with Sparganosis mansoni infection admitted in our hospital from Jan.1996 to Mar.2008 were investigated and relevant literatures were reviewed. Results The clinical feature of these 12 cases varied considerably and was manifested as symptoms of central nervous system in 5 patients, subcutaneous mass in 4 patients, chest pain and cough in 1 patient, ants crawling-like feeling all over the body in 1 patient and local swelling and ulceration of skin under the cover patch of frog skin in 1 patient. Serum anti-Spargnosis mansoni antibody was positive in all the 12 patients. Diagnosis was confirmed by pathologic examination of biopsy specimen and identification of worm body. There were 7 male and 5 female patients, male to female ratio was 1.4：1. Nine of the 12 patients had a history of frequently eating frogs and snakes. Conclusions The clinical manifestation of Sparganosis mansoni infection varies considerably. Epidemiological data should be collected and specific antibody test performed for avoiding miss and delay in diagnosis. Brain CT and MRI should be performed when necessary, and the diagnosis is confirmed by pathologic examination of biopsy specimen or identification of worm body.