云南省儿童并殖吸虫病临床与影像学特征分析

Clinical and imaging analysis for paragonimiasis in children in Yunnan Province

目的探讨儿童并殖吸虫病的临床表现、实验室检查与影像学表现,提高对儿童并殖吸虫病的诊断能力。方法以昆明市第三人民医院2016年1月1日至2019年12月31日确诊或临床诊断为并殖吸虫病的47例儿童为研究对象,回顾分析其临床表现、实验室检查及影像学表现资料。结果47例患者中,男性40例,女性7例,年龄为4~14岁。患儿均为云南籍,其中昭通地区42例,文山地区4例,玉溪地区1例。所有患儿均有生食溪蟹史。临床常见症状包括发热、咳嗽、咳痰、胸痛及头痛、腹痛等。实验室检查外周血嗜酸性粒细胞增多46例,患者免疫球蛋白IgE升高42例。影像学检查43例有胸腔积液,27例出现肺实变,其中伴“虫体隧道征”13例。结论儿童并殖吸虫病应根据血常规检查和胸部影像学检查结果,结合患儿流行病史和临床表现进行综合诊断,以减少误诊,做到早诊断、早治疗。

Objective To investigate the clinical picture,laboratory findings and imaging manifestations of paragonimus infection in children for improving the diagnosis of this disease in children.Methods Retrospective analysis was performed on the clinical picture,laboratory findings and imaging manifestations in 47 children confirmed or clinically diagnosed as paragonimiasis in our hospital between January 1,2016 and December 31,2019.Results Of the 47 patients,40 were boys,and 7 girls.The age ranged from 4 to 14 years old.All children were Yunnan nationalities,respectively from Zhaotong City(n=42),Weshan district(n=4)and Yuxi area(n=1),and generally had history of consuming raw stream shrimps and crabs.The common symptoms included fever,cough,chest pain,headache,and abdominal pain.Laboratory studies indicated elevated peripheral blood eosinophils in 46 cases,and serum immunoglobulin IgE in 42 cases.Imaging examination revealed pleural effusion in 43 cases,and lung consolidation in 27 cases,in which"worm tunnel sign"was seen in 13 cases.Conclusion Combined diagnosis of paragonimus infection in children with routine blood studies and chest imaging as well as consideration of the epidemic history and clinical manifestations,can reduce misdiagnosis,and lead to early conclusion and early treatment.