肺型肺吸虫病误诊后又发生皮肤型肺吸虫病一例

A case of secondary subcutaneous paragonimiasis misdiagnosed as pulmonary paragonimiasis

目的探讨预防肺吸虫病误诊的方法,分析血小板(PLT)和嗜酸性粒细胞(EOS)在肺吸虫病临床诊断中的价值。方法报告1例以"咳嗽4个月,右侧胸背部包块2个月"为主要临床表现的肺吸虫病患儿的诊疗过程中PLT和EOS水平变化,分析PLT和EOS在肺吸虫病诊断中的价值。结果因本例患者仅以临床症状、体征、胸部CT结果为诊断依据,未仔细询问个人史,未辨证分析PLT和EOS变化,导致多次误诊,并因误诊实施全身麻醉下包块切除术,经规范治疗患者PLT和EOS水平逐步恢复正常。结论辨证分析PLT和EOS是临床发现肺吸虫感染的关键,抗原和抗体检查是其确诊的依据。PLT和EOS为反映疗效的重要指标。

Objective To investigate the method of preventing misdiagnosis of paragonimiasis and the diagnostic value of platelets(PLT)and eosinophils(EOS)in paragonimiasis.Methods A case of paragonimiasis with cough for 4 months and subcutaneous mass for 2 months as the main clinical manifestation was reported.By detecting changes of PLT and EOS to explore the diagnostic value of platelets and eosinophils in paragonimiasis.Results Due to the clinical symptoms,signs and chest CT results as the basis for diagnosis,no personal history and no dialectical analysis in levels of PLT and EOS changes of this case,which resulted multiple misdiagnosis.Mass excision was performed under general anesthesia after misdiagnosis.EOS and PLT gradually returned to normal levels after treatment.Conclusions Dialectical analysis of PLT and EOS was the key process to clinical diagnosis of Paragonimiasis,and antigen and antibody screen is critical to confirm the diagnosis.EOS and PLT were important indicators for the curative effect.