江西省14例脑型血吸虫病临床特点

Clinical features of 14 cases of cerebral schistosomiasis in Jiangxi Province

目的探索脑型血吸虫病的临床特点。方法选择2010年3月至2016年3月江西省寄生虫病防治研究所临床部治疗的14例脑型血吸虫病人的临床资料进行分析。结果 14例患者中12例诊断为慢性型,2例诊断为急性型,血清、脑脊液均为血吸虫抗体阳性。嗜酸性粒细胞增高者10例,百分比为5.1%~60.3%。Kato-Katz法粪检查见血吸虫卵7例。13例行内科治疗,12例治愈,1例好转;1例手术切除病灶。结论脑型血吸虫病主要表现为癫痫、头痛、头昏、发热等。头颅MRI特征性影像呈簇状聚集融合成团块状。脑型血吸虫病口服吡喹酮治疗可以取得很好的预后。

bjective To discuss the clinical features of cerebral schistosomiasis. Methods The clinical data of fourteen patients with cerebral schistosomiasis from March 2010 to March 2016 were collected and analyzed retrospectively. Results The schistosomiasis immunological tests of sera and cerebrospinal fluids from the fourteen patients were all positive. Eosinophils increased in ten cases, and the proportion was 5.1%-60.3%. Schistosoma eggs were found in seven cases by the fecal Kato-Katz method. Fourteen cases were all infected with Schistosomejaponicum. Twelve cases were diagnosed as chronic type, and two cases as acute type. Thirteen patients received medical treatment, of which twelve were cured, and one improved. One patient received the surgical resection of the lesion. Conclusion The clinical manifestations of cerebral schistosomiasis mainly include seizure, headache, dizziness and fever. In the enhanced head magnetic resonance imaging （MRI）, the lesions are clustered and merged into lumps, which is the characteristic image of cerebral schistosomiasis japonica. The praziquantel treatment can achieve a good prognosis.