误诊为细菌性痢疾的嗜酸性胃肠炎两例分析

Analysis of 2 Cases of Eosinophilic Gastroenteritis Misdiagnosed as Bacterial Dysentery

目的分析嗜酸性胃肠炎(eosinophilic gastroenteritis, EG)的临床特点,为减少误诊及传染病误报提供依据。方法回顾性分析我院2例误诊为细菌性痢疾的以黏液脓血便为首发症状的EG临床资料。结果 2例均因急性腹泻、腹痛伴发热及黏液脓血便就诊,均曾误诊为细菌性痢疾,1例合并皮疹,2例均应用抗感染治疗无明显效果,便检均有黏液脓血便伴嗜酸粒细胞升高,肠黏膜病理检查示嗜酸粒细胞浸润,对糖皮质激素治疗有效。遂均确诊为EG,均随访1年无复发。结论 EG临床表现缺乏特异性,大多以腹痛、呕吐等症状常见,少有以黏液脓血便为首发症状者,易误诊误治。

Objective To analyze the clinical characteristics of eosinophilic gastroenteritis(EG), and to provide the basis for reducing misdiagnosis and misreport of infectious diseases. Methods The clinical data of 2 cases of EG misdiagnosed as bacillary dysentery with mucopurulent blood as the initial symptom was retrospectively analyzed. Results Two patients presented to our hospital for acute diarrhea, abdominal pain with fever and mucopurulent bloody stool. They were misdiagnosed as bacterial dysentery, which was complicated by skin rash in one case. No obvious effect was observed in 2 cases after treatment with anti-infection therapy. The stool examination showed mucopurulent bloody stool with eosinophilia. Pathological examination of intestinal mucosa showed eosinophil infiltration, and those patients were sensitive to hormone therapy. All patients were diagnosed as EG, and there was no recurrence at 1-year follow-up. Conclusion Clinical manifestations of EG is lack of specificity. Most of them are common symptoms such as abdominal pain and vomiting, and few of them are digestive system diseases with mucopurulent bloody stool as the initial symptoms, which, therefore, are more likely to be misdiagnosed and mistreated.