重症牛带绦虫感染者1例

<正>患者,男,44岁,货车司机,新疆维吾尔自治区乌鲁木齐米东区古牧地镇东工村人。自1999年起15年间3次排出牛带绦虫(Taenia saginata)节片。既往病史如下,1999年首次将肛门排出的孕节送新疆医科大学基础医学院人体寄生虫学教研室(以下简称本教研室)寻求诊疗帮助,经吡喹酮10 mg/kg顿服配合硫酸镁导泻后驱出虫体碎片,治疗后3月内无节片排出。2004年第2次排出孕节,至米泉县医院     

四川雅江县和甘肃岷县绦/囊虫病流行现状调查

目的了解我国西部藏族地区四川省雅江县及甘肃省岷县绦/囊虫病的流行现状。方法采用以询问排节片史为主的方法对雅江县和岷县绦/囊虫病病例进行调查,用槟榔-南瓜子法对调查到的病人进行驱虫治疗,对驱出的成虫进行形态学鉴定和测量。结果在雅江县呷拉乡及瓦多乡的7个村寨共调查1137人,有自觉症状的病人73例,经驱虫治疗后有2人排出猪带绦虫,21人排出牛带绦虫,另发现皮下结节患者18例,脑囊虫病患者2例。在岷县寺沟乡及秦许乡的6个村寨共调查652人,27例有排节片史病人均未驱出绦虫,岷县确诊的脑囊虫病患者17例。结论目前四川省雅江县及甘肃省岷县存在绦/囊虫病的流行,其原因是当地藏民喜欢生吃猪肉和牛肉;岷县囊虫病的流行可能与当地农民接触粪便机会较多有关。     

云南、贵州两省38条人体带绦虫的分子鉴别

目的对采自云南、贵州两省的38条人体带绦虫进行分子鉴别,了解当地猪带绦虫、牛带绦虫和亚洲带绦虫的分布状况。方法对云南大理和贵州都匀及从江地区有排节片史的病人以槟榔-南瓜子法驱虫,虫体经形态学初步鉴别后,以组织DNA提取试剂盒提取虫体基因组DNA,分别采用亚洲带绦虫、牛带绦虫和猪带绦虫线粒体细胞色素C氧化酶亚单位1基因(cox1)片段的特异性引物对各DNA样品进行常规PCR扩增和琼脂糖凝胶电泳检测;PCR阴性样品采用带绦虫cox1片段PCR通用引物进行扩增,并选择1份亚洲带绦虫特异性PCR阳性的样品作为对照。从3种带绦虫PCR阳性的扩增产物中各选择1份进行核酸序列测定,并用NCBIBlast将各核酸序列与GenBank数据库中带绦虫的cox1进行比对分析。结果采自大理的4条带绦虫(DL1～4)的猪带绦虫cox1片段PCR为阳性,扩增产物约980bp;其余25条大理带绦虫(DL5～29)和5条都匀带绦虫(DY1～5)的亚洲带绦虫cox1片段PCR为阳性,扩增产物约260bp;各样品的牛带绦虫cox1片段PCR均为阴性。DL2PCR产物的核酸序列与GenBank中猪带绦虫cox1的同源性为99%～100%,DY1PCR产物的核酸序列与亚洲带绦虫cox1的同源性为100%。特异性PCR均阴性的4条从江带绦虫(CJ1～4)和亚洲带绦虫特异性PCR阳性的DL7以带绦虫cox1片段通用引物的PCR扩增出约1kb的产物。测序表明,CJ1片段的核酸序列与牛带绦虫cox1的同源性为99%,DL7与亚洲带绦虫cox1的同源性为99%～100%。结论cox1片段PCR扩增和核酸测序分析表明,采集的云南大理人体带绦虫为猪带绦虫和亚洲带绦虫,贵州都匀和从江人体带绦虫分别为亚洲带绦虫和牛带绦虫。     

浙江省首例本地感染牛带绦虫的诊断和治疗

目的对浙江省1例本地感染绦虫病例进行诊断和治疗,并确定其所感染绦虫的种类。方法收集患者发病、临床表现、诊治过程等信息,对患者开展流行学调查。采用肛周透明胶纸法检查虫卵。使用槟榔-南瓜子进行驱虫治疗,对患者排出的虫体进行形态学观察,采用PCR扩增虫体DNA的线粒体细胞色素C氧化酶1(cytochrome C oxidase 1,COX1)基因片段并进行序列分析。结果流行病学调查结果显示,患者近两年无县外出行史,无食生猪肉、牛肉或动物内脏史,但经常食用烧烤肉类及火锅,偶尔食用生蔬菜。患者肛周皮肤检查发现带绦虫虫卵。患者排出的虫体经形态学观察疑似为牛带绦虫(Taenia saginata)或亚洲带绦虫(Taenia asiatica)。PCR扩增COX1基因片段获得832 bp扩增产物,测序后经Bl AST比对分析显示,与牛带绦虫COX1基因(Gen Bank登录号为AB107239.1)序列相似性为99%,而与亚洲带绦虫(Gen Bank登录号为AB107235.1)和猪带绦虫(Taenia solium,Gen Bank登录号为AB066485.1)COX1基因序列相似性分别为96%和88%。结论综合患者的临床特征、流行病学信息和排出虫体的序列分析结果 ,确认该病例为本地感染牛带绦虫病例。     

改良南瓜子、槟榔煎剂驱绦虫效果观察

1995年以来 ,作者运用南瓜子、槟榔煎剂治疗绦虫病病人2 2例 ,取得了满意疗效 ,现报道如下。1　临床资料1　病例选择　 2 2例病人均为镜检确诊的绦虫病患者 ,在近 1个月内大便中排出过绦虫节片。2　一般资料　 2 2例患者 ,男 11例 ,女 11例 ,年龄最小 3岁 ,最大 48岁。病史最短 1d,最长 2年。伴有皮下囊虫结节 9例 ,合并脑囊虫 14例。有 5例病人曾接受过驱虫治疗 ,其中 2例服西药 (药物不详 )驱虫 ,未见虫体排出 ;1例服灭绦灵后仅排出数节绦虫节片 ;1例服肠虫清未见驱出虫体 ;另 1例服南瓜子和槟榔煎剂 ,服后呕吐频繁 ,未见驱出虫体。 5例病…     

1例牛带绦虫感染病例报告

目的报道1例牛带绦虫感染病例的诊断与治疗。方法通过对患者驱出的虫体进行形态学鉴定,根据虫体肉眼形态、显微镜下虫卵形态、孕节子宫分支情况,结合流行病学史进行诊断。结果判定患者为牛带绦虫感染,采用槟榔-南瓜子方法对其进行驱虫治疗、随访。结论此次牛带绦虫病是因生食或半生食含有囊尾蚴的牛肉所感染的。为改变人群不良卫生习惯和生活方式,阻止牛带绦虫病的流行,应加强相关健康教育工作。     

牛带绦虫病2例报道

例 1:男 ,3 2岁 ,黑龙江人。 2 0 0 1年到宁夏打工半年后 ,发现粪便内有白色“虫体”排出。当地医院给予“肠虫清”口服 ,4片 /次 ,tid ,连服 6d。 2 0 0 2年来青岛打工 ,仍发现有“虫体”排出 ,再次服用“肠虫清”无效 ,到我室诊治。患者一般状况尚好 ,但较消瘦。自述经常腹部不适 ,肛门瘙痒 ,有时腹痛、腹泻。自发现“虫体”以来 ,精神紧张 ,经常失眠。患者带来的“虫体”经鉴定为牛带绦虫孕节 ,诊断为牛带绦虫病。治疗 :空腹嚼服新鲜南瓜子约 10 0 g(农贸市场购买 ) ,1h后服槟榔 (浸泡过夜 )煎剂 2 0 0ml ,3 0min后加服 5 0 %硫酸镁 3 0m…     

2016-2019年大理市带绦虫病疫情监测结果分析

目的 了解大理市带绦虫病流行现状和动态,掌握流行规律,预测流行趋势,为制订防治规划提供依据。 方法 2016-2019 年,在大理市开展带绦虫病病史调查和粪检查病,对自愿接受驱绦治疗的部分感染者和自述有排节片史而粪检阴性居民进行驱虫治疗,后者驱出带绦虫完整虫体或节片者判为阳性,计入查病结果。 结果  2016-2019 年,带绦虫感染率依次为 2. 94%、2. 26%、0. 93%和 0. 33%,呈逐年下降趋势。 年平均感染率男性(2. 13%) 高于女性(1. 18%);14~组(2. 44%)高于 3~组(0. 47%)和 60 ~ 组(1. 18%);农民组(1. 99%)高于在校学生组(0. 64%);文盲或半文盲组(3. 56%)高于学龄前儿童及小学组(1. 49%),也高于中学组(1. 25%);所有感染者均为白族。 教师、村干部及大学专科及以上居民 4 年均未查到阳性。 结论 当前大理市带绦虫病疫情处于历史最低水平,但市民喜食生肉、生猪肝等习惯依然存在,因此带绦虫病防治工作还面临诸多挑战,应进行综合治理。     

大头金蝇幼虫致肠蝇蛆症一例

患者女,14岁,藏族,西藏江孜人,系山东济南某中学藏族学员班学生,一般情况可,发育正常。以往有经常恶心、腹痛、腹胀、食欲减退及肛门周围瘙痒等。经透明胶纸法肛周检查带绦虫卵阳性,于1989年10月22日服用南瓜子、槟榔及硫酸镁等药物驱虫。服药后在驱出三条牛肉绦虫完整成虫的同时,随大便排出蝇蛆两条,其中一条排出时已死亡,虫体瘪软,尚完整,呈灰白色,形态特征清     

甘露醇导泻驱牛带绦虫的临床体会

198 8 -2 0 0 0年我院采用南瓜子和槟榔驱牛带绦虫 ,并分别用硫酸镁和甘露醇两种方法导泻 ,结果表明用甘露醇效果较好。1　方法自诉有扁形虫体节片自大便中排出或自肛门逸出者作为治疗对象。硫酸镁组 :治疗当天上午空腹服南瓜子 80 g,2 h后服80 g槟榔煎剂约 2 0 0 ml,再过 0 .5 h服 2 5 %硫酸镁溶液1 0 0 ml。甘露醇组 :南瓜子和槟榔用法同上 ,服后 0 .5 h服2 0 %甘露醇 2 5 0 ml,1 h后再服 5 %葡萄糖生理盐水1 0 0 0 ml。排出虫体后常规化验检查 ,确认虫体及头节是否完整排出。2　结果硫酸镁组 1 8例 ,驱出虫体 8例 ( 4 4.4 % ) ,其中带头…     

猪带绦虫孕节片内虫卵的数量与成熟率的观察

目的　观察猪带绦虫成虫孕节片含卵数量与成熟率。　方法　对 10条猪带绦虫成虫孕节末端 10个孕节片内虫卵进行计数并计算其成熟率。　结果与结论　 10条猪带绦虫每节成熟孕节片内虫卵数量不等 ,悬殊较大 ,一个孕节片含卵数最高达 12 6 5 2 0个 ,最少 390 0个 ,平均 2 8332个。成熟率最高为 36 .0 % ,最低为 7.0 % ,平均为 2 9.1% ,较绦虫成虫自动脱落随患者粪便排出之孕节片内虫卵成熟率为低。另外 ,在适宜温度与湿度条件下 ,排出宿主体外的孕节片内虫卵仍可继续发育 ,2～ 3d后 ,成熟率可提高至 85 %～ 90 %。     

我国西部4地牛带绦虫成虫的形态学观察

目的 比较观察贵州省都匀、从江新疆乌什和西藏拉萨等4地牛带绦虫成虫的形态学特征。 方法 分别测量采自都匀（42条）、从江（41条）、乌什（7条）和拉萨（18条）等4地完整牛带绦虫成虫的长度，计数链体节片数，并采用整体染色封制法观察头节、成节和孕节的形态结构，进行显微测量、计数和摄影。结果 都匀的成虫平均长为（1.81±0.69）m，显著短于从江的（3.84±1.32）m、乌什的（2.76±0.86） m和拉萨的（3.72±1.12）m成虫（P<0.05）。都匀成虫的链体平均节片数为（574.64±189.33），也显著少于从江的（913.84±317.41）、乌什的（971.29±168.30）和拉萨的（940.38±368.26） （P<0.05）。都匀牛带绦虫成节的排泄管间距与卵黄腺长度比值平均为（1.71±0.13）， 明显小于从江的（2.23±0.06）、乌什的（2.03±0.21）和拉萨的（2.31±0.15）比值（P<0.05）。染色观察都匀牛带绦虫10个头节中有3个明显可见发育不良的顶突。 结论 都匀的牛带绦虫成虫形态特征与牛带绦虫亚洲亚种相似，而从江、乌什和拉萨等3地的牛带绦虫成虫形态特征与牛带绦虫指名亚种相似。     

Usefulness of pumpkin seeds combined with areca nut extract in community-based treatment of human taeniasis in northwest Sichuan Province, China

Taeniasis refers to the infection with adult tapeworms of Taenia spp. in the upper small intestine of humans, which is also a cause of cysticercosis infection in either both humans and/or animals. Currently the most commonly applied anthelminthics for treatment of taeniasis are praziquantel and niclosamide. Praziquantel is very effective, but has the risk of induction of epileptic seizures or convulsions in carriers with asymptomatic concurrent neurocysticercosis. In contrast, niclosamide is safe and effective, but is not readily available in many endemic countries including China. In the current community-based study, we assessed the curative effect of either pumpkin seeds or areca nut extract alone in taeniasis, and also looked at synergistic effects of these two herb drugs on tapeworms. In the study group with the pumpkin seed/areca nut extract treatment, 91 (79.1%) of 115 suspected taeniasis cases (with a history of expulsion of proglottids within the previous one year) released whole tapeworms, four (3.5%) expelled incomplete strobila, and no tapeworms or proglottids were recovered in the remaining 20 cases. In these 115 persons, 45 were confirmed as taeniasis before treatment by microscopy and/or coproPCR. Forty (88.9%) of 45 confirmed cases eliminated intact worms following treatment. The mean time period for complete elimination of tapeworms in 91 taeniasis cases was 2h (range 20min to 8h 30min), and 89.0% (81) of 91 patients discharged intact worms within 3h after drug administration. In Control Group A with treatment of pumpkin seeds alone, 75.0% (9/12) of confirmed taeniasis cases expelled whole tapeworms, but the mean time period for complete elimination was about 14h 10min (range 3h 20min to 21h 20min), which was much longer than that (2h) for the study group, whereas in Control Group B treated with areca nut extract alone, only 63.6% (7/11) of taeniasis cases discharged whole tapeworms, and the mean time period was 6h 27min (range 1-22h). Mild side effects included nausea and dizziness in about 46.3% of patients with the pumpkin seeds/areca nut extract treatment, but all discomforts were transient and well tolerated. In conclusion, a synergistic effect of pumpkin seed and areca nut extract on Taenia spp. tapeworms was confirmed in the current study, primarily in producing an increased rate of effect on tapeworm expulsion (average time 2h for combination vs 6-21h for individual extracts). The pumpkin seed/areca combined treatment was indicated to be safe and highly effective (89%) for human taeniasis.     

Co-occurrence of parasites sensu lato in alimentary tract of patients hospitalised in lower Silesia

Up to now, the co-occurrence of parasites sensu stricto and fungi were confirmed mostly in the oral cavity. The aim of the present parallel parasitological and mycological investigations was to determine co-occurrence of protozoa, helminths and fungi (parasites sensu lato) both in smears from cavity and in stool samples of 93 patients undergoing the non-parasitological treatment in two hospitals of Lower Silesia (Poland). Among the examined patients parasites sensu lato (13 species) were found in 62 cases (63%). Trofozoites of Trichomonas tenax and/or Entamoeba gingivalis as well as fungi (Candida albicans, C. krusei, C. tropicalis and C. pseudotropicalis) occurred in 10% of the examined patients. Almost all infected cases (90%) were joined with infection of common invasion of protozoa and fungi. In stool common invasion of parasites sensu lato (Giardia intestinalis, Entamoeba coli, Ascaris lumbricoides, Taenia sp., Enterobius vermicularis as well as Candida albicans, C. krusei, C. pseudotropicalis, C. guilliermondii and Rhodotorula sp.) were found in 12% of the patiens. The co-occurrence of parasites and fungi was stated in the half of invasions. C. albicans was the most often co-occurring species in alimentary tract.     

Taeniasis in Mongolia, 2002-2006

Survey on secondary data of taeniasis/cysticercosis was carried out in Mongolia in 2002-2006. A total of 118 taeniid proglottids, a diphyllobothriid segment, and 59 serum samples from 118 taeniasis cases were collected at National Center for Communicable Diseases, Ulaanbaatar, Mongolia. In 2006, 14 serum samples were collected from local people who had histories of epileptic seizures in Selenge Province where pig husbandry was the main business. The 118 proglottids were confirmed to be Taenia saginata by mitochondrial DNA analysis using cytochrome c oxidase subunit 1 and cytochrome b genes. T. saginata taeniasis was widely distributed at least in 10 of 21 provinces. No variation in the nucleotide sequences of the two genes was observed among T. saginata isolates from Mongolia. There was no evidence of Taenia solium taeniasis/cysticercosis or Taenia asiatica taeniasis. A diphyllobothriid segment was confirmed to be Diphyllobothrium latum by mitochondrial DNA analysis.     

Prevalence and risk factors for Taenia solium taeniasis and cysticercosis in humans and pigs in a village in Morelos, Mexico.

In a Mexican village in which Taenia solium infection was known to be endemic, we selected a cluster sample of 368 households (21% of the total) for demographic, environmental, and diagnostic surveys, and medical histories for taeniasis and cysticercosis. Coproparasitologic studies of 1,531 participants revealed infection by Taenia sp. in four (0.3%) individuals; however, 5.8% of the respondents reported a history of having passed tapeworm proglottids in feces. Of 1,552 human serum specimens, 10.8% tested positive in the cysticercosis immunoblot assay. Seropositivity increased with age and reached a maximum in subjects ages 46-55 years. Risk factors associated with seropositivity included a history of passing tapeworm proglottids, frequent consumption of pork, and poor personal and household hygiene (P less than 0.05). A history of seizures was also significantly associated with seropositivity (P less than 0.05); approximately one-third of persons with such histories were seropositive. Of 571 pigs examined by tongue inspection, 23 (4.0%) had cysticerci; infection rates increased with the age of pigs, and were higher in pigs that habitually ran loose or were fed human feces (P less than 0.05). Goodness of fit analysis confirmed that seropositive persons (but not infected pigs) were significantly clustered within households, particularly, in households in which a member reported a history of having passed tapeworm proglottids. The results of this study have identified community behavioral and environmental practices that must be modified to prevent continued transmission of cysticercosis and taeniasis.     

Detection of helminth infections in dogs and soil contamination in rural and urban areas

A study was conducted to determine the helminthes in dog's feces and soil samples from urban and rural areas. Six species of nematodes (Toxocara sp, an undetermined nematode larvae, Strongyloides sp larvae, Ascaris sp ova, hookworm ova, Trichuris sp ova) and one species of Cestode (Taenia sp) were found in 175 stool samples. Seventy-eight point nine percent of stool samples were positive for helminthes. Mixed infection with at least one parasite was found in 32.6% of the samples. The prevalence of helminth infection ranged from 1.1% to 45.1%. The prevalence of hookworm sp was the highest with 45.1%. The highest prevalence in urban dogs was hookworm sp in 76.7% and in rural areas was Ascaris sp in 48.7%. Soil samples were also examined to determine contamination of the environment, especially due to Toxocara canis, as a potential source of infection. Urban soil samples showed a higher contamination rate with 26.7% compared to rural areas with 4.9%. Toxocara ova were the most prevalent helminthes contaminating the soil with 12.1%. This study showed that humans from both urban and rural areas are at risk of acquiring helminth infection from contaminated soil.     

Unusual colonoscopy finding： Taenia saginata proglottid

Infection with tapeworms is a major problem in many parts of the world. Patients may be asymptomatic or have a significant morbidity depending on the species. Infection with Taenia species is sometimes found by expulsion of eggs or proglottids in stool. Species specific diagnosis of Taenia is difficult, but possible. We present a case of Taenia saginata incidentally discovered, and risk factors for transmission, diagnosis, symptoms, and treatment.     

我国西部6省9地牛带绦虫rDNA-ITS1序列测定及分析

目的利用分子生物学技术鉴定我国6省9地是否存在牛带绦虫亚洲亚种。方法取成虫标本孕节2~3片,酚氯仿法提取DNA,PCR法扩增rDNA-ITS1片段,并纯化、克隆此片段后作序列测定。利用BioEdit,clustalx,PHYLIP,Treeview软件处理后构建系统发育树。结果广西融水(RS)、宾阳(BY)牛带绦虫标本与贵州都匀(DY),云南大理(DL)牛带绦虫标本序列基本一致,同源性为98%~99%;新疆乌什(WS)、西藏拉萨(LS)、内蒙古(NM)、云南西双版纳(BN)牛带绦虫标本与贵州从江(CJ)牛带绦虫标本序列基本一致,同源性为98%~99%。系统发育树显示:RS、BY、DL和DY标本遗传距离较近;WS、LS、CJ、NM和BN标本遗传距离较近。而两组间遗传距离较远。结论RS、BY、DL和DY四地存在牛带绦虫亚洲亚种;WS、LS、CJ、NM和BN五地存在传统牛带绦虫。     

Prevalence of Blastocystis hominis infection in asymptomatic individuals from Bangkok, Thailand

Fresh stool examination was performed from 2,230 participants who enrolled in annual check-up programs of the Faculty of Medical Technology, Mahidol University in 1999-2000 and 2004. In this study, Blastocystis hominis infection was diagnosed by culturing in Jones' media. A total of 21% of fecal specimens (in 1999-2000) and 13.7% (in 2004) were positive for B. hominis. The vacuolated form was the predominant form found in culture solution after 48 hours of incubation. The distribution of infection was highest between the ages of 21-30 years (p<0.05). There was no significant difference in infection between male and female groups. Other parasites, eg Giardia lamblia, Entamoeba histolytica, Entamoeba coli, Endolimax nana, Trichomonas hominis, Strongyloides stercoralis, Opisthorchis viverrini and Taenia species, were also found by fresh stool examination.