Clinical analysis of 48 cases with parasitic infection of liver
0
Citation
0
Reference
20
Related Paper
Abstract:
Objective To analyze clinical characteristics of 48 cases with parasitic infection of liver,facilitate clinical diagnosis and therapy.Methods Clinical data of 48 cases hospitalized in department of Infectious Diseases,People′s Hospital of Sichuan Province in April 2010 to July 2010 were collected,investigated epidemiology,clinical manifestation,pathogen,lab examinations,abdominal CT images and therapy.Results All patients ever had uncooked loach.Symptoms include fever,fatigue,upper quadrant abdominal discomfort and pain,malaise,myalgia,diarrhea,mild elevated aminotransferase,mild to severe hypereosinophilia and multiple hypodense lesions seen on computed tomography(CT) scan.The metacercariae were found in muscles of loach.One or several serum antibody of bladder worm,hydatid,paragonimiasis,liver flukes and schistosome were positive in patients.Eggs were found in 3 cases,which similar to those of Fasciolopsis buski.All cases were cured by oral praziquantel.No case was recurrence in follow-up at least 1 month.Conclusion To eat uncooked loach may be caused parasitic infection of liver similar to Fascioliasis.Diagnosis is based on epidemiology,clinical manifestation,lab examinations and abdominal CT images.Oral praziquantel is safe and efficacious.Keywords:
myalgia
Malaise
Cite
We report a case of a 39 year old male who presented with nausea and right upper quadrant pain. Marked eosinophilia and a hypoechoic liver lesion on ultrasound were identified. The differential diagnosis included neoplasms, infectious diseases and hepatic abscess. Indirect hemagglutination test using purified adult Fasciola hepatica f1Ag confirmed serologic diagnosis of fascioliasis. Radiologists should keep in mind the importance of correlating imaging, clinical and laboratory findings in order to reach the correct diagnosis.
Quadrant (abdomen)
Cite
Citations (9)
In recent years, the number of humans infected with Fasciola has risen rapidly. Diagnosis is based mainly on detection of eggs in stool analysis. The rate of infection in Egypt is unknown. In this retrospective study, we describe 23 cases of hepatic fascioliasis, and only 2 of these cases showed eggs in stools. The symptoms of infection, such as pyrexia of unknown origin, epigastric pain, and abdominal distension, were suggestive. Imaging techniques, including abdominal ultrasonography and computed tomography, were very helpful in detecting hepatic changes. An indirect hemagglutination assay proved to be of value for diagnosis. Treatment using a 2-day triclabendazole regimen cured the infection and signs of hepatic involvement disappeared. Combining both imaging techniques and laboratory tests is essential for diagnosis of fascioliasis in the early stage.
Triclabendazole
Fasciola
Abdominal distension
Clonorchiasis
Epigastric pain
Cite
Citations (38)
Examination of twenty parasitologically proven human cases of fascioliasis showed the following clinical, laboratory and ultrasonography results: (1) Both sexes are susceptible to fascioliasis. The smallest one was a child 3-year old. (2) The most important clinical manifestations are: a- abdominal distention and flatulence (30%), b- right upper quadrant pains (25%), colicky abdominal pains (25%), d- pallor (25%), and etympanitic abdomen (25%). Nevertheless, 15% of the patients showed no symptoms. (3) The most significant items in the CBC and liver function tests are: a- significantly high eosinophilia, b-high alkaline phosphatase, and c- low haemoglobin. Besides, two fascioliasis patients had high serum bilirubin. (4) Ultrasonography diagnosed only nine fascioliasis patients (45%). The result was critically discussed.
Pallor
Abdominal ultrasonography
Cite
Citations (14)
Objective To clinically analyze the hepatobiliary disease caused by the liver fluke and to increase the knowledge of this disease and reduce misdiagnosis.Methods A retrospective analysis was performed on the clinical data of 22 patients who had a confirmed diagnosis of clonorchiasis after being admitted to our hospital due to hepatobiliary disease over the past 20 years.Results Of the 22 patients,who had a mean age of 45.41 years,19 were males,and 3 were females.When admitted to the hospital,8 cases were diagnosed with cholecystitis or gallstones,7 cases with clonorchiasis,and 7 cases with other diseases.Alanine aminotransferase elevation was found in 14 cases(63.63%),aspartate aminotransferase elevation in 16 cases(72.72%),total bilirubin elevation in 11 cases(50.00%),gamma-glutamyl transpeptidase elevation in 17 cases(77.27%),and increased eosinophils in 14 cases(63.63%).Ten cases(45.45%) were diagnosed by fecal examination,7 cases(31.82%) by bile smears,2 cases(9.09%) by liver fluke antibody detection,and 3 cases(13.64%) according to the history of clonorchiasis.Deworming and comprehensive treatment produced a good outcome in these patients.Conclusion Clonorchiasis is endemic and clinically rare,without specific clinical features,and it is easily confused with other hepatobiliary diseases,resulting in a high rate of misdiagnosis.Therefore,for the patients with abdominal pain,jaundice,and liver damage of unknown causes,we should inquire whether they or their family have a special dietary history and need to perform relevant examinations to confirm the diagnosis,so as to provide timely treatment.
Clonorchiasis
Clonorchis sinensis
Liver disease
Cite
Citations (0)
Objective To explore the clinical features,diagnosis and treatment for children with cerebral paragonimiasis.Methods Among all the 59 patients,52 had a history of consuming raw crabs or drinking contaminated water,49 got intracranial hypertension,10 suffered hemiparalysis or hemiablepsia,19 had epileptic seizure,and 6 complicated with pulmonary symptoms.Forty-five got increased eosinophilic leukocytes in peripheral blood,36 had increased leucocytes.Skin test of Paragonimus westernami antigen was positive in 45 cases and ELISA test was positive in 15 cases.Intracerebral lesions were found in all the cases by CT or MRI examination.Results All patients underwent oral administration of Praziquantel.and 14 got craniotomy.Forty-one cases were cured and 18 cases partially recovered.Forty-three patients who were followed up for 6 months to 2 years had good prognosis.Conclusions Cerebral paragonimiasis in children has complex clinical manifestations,which is often misdiagnosed in the early stage.Epidemiology,increased eosinophilic leukocytes in peripheral blood.positive results of paragonimiasis immunology test and MRI contribute to early diagnosis.Drug or surgical treatment according to patient's different conditions can promise the good prognosis in children with cerebral cerebral paragonimiasis.
Key words:
Schistosomiasis; Diagnosis; Treatment
Paragonimus
Paragonimus westermani
Cite
Citations (0)
We report four cases who were referred to Mansoura University Teaching Hospital, Egypt suffering from abdominal pain and gastrointestinal manifestations. The patients' history was unremarkable, except that they had contact with dogs and live in rural communities. Laboratory findings showed peripheral blood eosinophilia, leucocytosis, and elevated liver enzymes. Serological tests were positive in three cases. Ultrasonography showed well-circumscribed cystic masses in the liver. Diagnosis of hydatid cysts was confirmed by computed tomography (CT). Surgical treatment along with chemotherapy was performed and all patients recovered well. The results of these cases support the notion that CT scan can led to increased clarity, regarding surgical management, because of discordance between radiographic and laboratory findings.
Albendazole
Abdominal ultrasonography
Cite
Citations (22)
목적: 성인에서 간농양으로 발현된 톡소카라증 환자들을 분석하여 임상양상, 검사 소견, 치료 및 경과를 알아보고자 하였다. 방법: 2008년 1월부터 2011년 7월까지 톡소카라증에 의한 간농양 환자 14명을 후향적으로 분석하였다. 환자들의 증상, 직업력, 식습관, 애완동물 접촉 여부, 알레르기 질환 유무, 말초혈액 호산구 수, 혈청 IgE, 다른 장기의 동반 침범 유무 등을 조사하였다. Albendazole 치료 후 CT, 말초혈액 호산구 수, 혈청 IgE를 추적검사하여 반응을 평가하였다. ê²°ê³¼: 총 568명의 간농양 환자 중 14명(2.5%)에서 톡소카라증에 의한 간농양으로 진단되었으며 남자가 9명, 여자가 5명이었다. 우상복부 또는 심와부 통증이 4예(28.6%), 기침 1예가 있었고 나머지 9예(64.3%)에서는 특이 증상이 없었다. 폐 침범이 5예(35.7%), 대장 침범이 1예(7.1%) 있었으며, 6예(42.9%)에서 소의 육회나 간을 생식한 과거력이 있었다. 직업력, 알레르기 병력에서는 특이사항이 없었으며 애완동물과 접촉한 경우도 없었다. 내원 초기 혈액검사에서 호산구 수와 IgE는 모두 상승되어 있었고 초기 복부 CT에서는 단일 또는 다발성의 경계가 불분명한 저음영 병변이 관찰되었다. Albendazole 치료 1개월 후 호산구 수는 대부분(93%) 정상화 또는 감소되었으나 IgE는 다양한 반응을 보였다. CT에서 관찰되었던 간농양은 치료 6개월 내에 대부분(92%)의 환자에서 소실되었다. ê²°ë¡ : 톡소카라증에 의한 간농양은 일반적인 화농성 간농양과는 임상양상, 검사 소견, 치료 등에서 차이점을 보인다. 호산구 증가증을 동반한 간농양 환자에서 조기에 톡소카라 항체를 포함한 혈청 검사가 시행된다면 진단 및 치료에 도움을 줄 수 있을 것이다. 중심 단어: 톡소카라증; 간농양
Albendazole
Cite
Citations (1)
To investigate the clinical features, diagnosis and treatment of paragonimiasis, so as to improve the prevention and treatment of it.The clinical data of paragonimiasis patients were collected and retrospectively analyzed.Totally 17 patients were diagnosed as paragonimiasis and the main clinical features of 11 patients were cough, chest pain and fever, and the pleural effusion was found in 13 cases. Peripheral blood eosinophil percentages of all patients were significantly increased, and the detections of antibody IgG againstParagonimus parasite of ELISA method were positive in all patients. All the patients were cured after praziquantel treatment and no recurrence found in the follow-up visit.The clinical features of paragonimiasis patients are diverse, and pleural effusion is quite common in imaging examinations. The eosinophil percentages and antibody detections have important values for the diagnosis of paragonimiasis. Praziquantel is an effective medicine in the treatment.［摘要］ 目的 探讨并殖吸虫病的临床表现、诊断及治疗, 提高并殖吸虫病防治水平。方法 收集并殖吸虫病患者的 临床资料进行回顾性分析。结果 共确诊并殖吸虫病患者17例, 其中11例患者以咳嗽、胸痛、发热为主要临床表现, 13 例患者存在胸腔积液。17例患者的末梢血嗜酸性粒细胞比例29.9%～59.3%, 并殖吸虫抗体IgG (ELISA) 均为阳性。经 吡喹酮治疗后, 所有患者均治愈, 随访1~2年无复发。结论 并殖吸虫病患者临床表现形式多样化, 影像表现则以胸腔 积液多见。末梢血中嗜酸性粒细胞增多及并殖吸虫抗体检查有助于此病诊断, 吡喹酮治疗效果确切。.
Paragonimus
Cite
Citations (1)
Sparganosis
Leukocytosis
Cite
Citations (11)
Fascioliasis is a worlwide parasitic zoonosis, endemic in south-east mediterranean area, but uncommon in other areas. Clinical signs are usually non-specific. A 32 year old male patient was admitted to our hospital with complaints of abdominal pain, diarrhea, fatigue, nausea, lost of appetite, itching, cough, night sweats and weight loss. Complete blood count revealed hypereosinophilia. The abdominal ultrasound scan was normal. But computed tomography scan revealed irregular nodular lesions in periportal area of the liver. Based on these clinical and radiological signs and continuous hypereosinophilia, the patient was serologically investigated for Fasciola hepatica infection. F. hepatica indirect hemagglutination test in serum was positive at a titer of 1/1280. Single dose Triclabendasole 10mg/kg was administered and repeated two weeks later. Clinical and laboratory signs were completely resolved after treatment. Serological tests for fascioliasis should be included in all patients with hypereosinophilia and abnormal liver CT.
Hypereosinophilia
Cite
Citations (5)