小儿肺吸虫病23例临床分析

目的　探讨小儿肺吸虫病的临床特点。方法　对 2 3例肺吸虫病患儿的临床资料进行分析总结。结果肺吸虫病发病年龄以学龄前或学龄期儿童多见 ,6 5 .2 %的患儿有吃石蟹、蛄或疫水接触史 ,临床表现以发热、咳嗽最为常见 ,分别占 87%及 73.9% ,其次为肝肿大和腹痛 ,皮疹、皮下结节、多浆膜腔积液偶见。 6 5 .2 %胸片有异常改变。外周白细胞增高占 78.3% ,嗜酸性粒细胞增高为 73.9% ,17.4 %患儿合并肺炎支原体、沙眼衣原体感染。用吡喹酮治疗均获治愈或好转。结论　肺吸虫病临床表现较复杂 ,临床上应提高对本病的认识和警惕。肺吸虫抗原皮试和 (或 )循环抗体测定可以确诊 ,吡喹酮治疗肺吸虫病疗效满意

Clinical analysis of 23 cases with infantile paragonimiasis

Objective To study the clinical features of infantile paragonimiasis. Methods The clinical materials of 23 cases with infantile paragonimiasis were summarized.Results Most cases with paragonimiasis were found in the preschool and school aged children. In our study, 15 out (65.2%) of 23 cases had the history of eating stream crab?cyayfish or drinking contaminated water. The major clinical manifestations were fever and cough, the incidences were 87% and 73.9% respectively. Hepatomegaly and abdominal pain were often met too. On the contrary, skin rashes, subcutaneous nodules and multiple dropsy of serous cavity were rare. 65.2% of total patients showed abnormal changes on chest film. Leukocytosis and eosinophil granulocytosis were 78.3% and 73.9% respectively. 17.4% of all cases were complicated with Mycoplasma pneumoniae and Chlamydi trachomatis infection. Praziquental was effective to all patients. Conclusion The clinical manifestations of paragonimiasis were variable, many cases did not have the history of eating stream crab, crayfish or drinking contaminated water and their chest film or WBC were normal, therefore, it was easy to misdiagnose. Paragonimus antigen intradermal test and circulating antibody test could confirm the diagnosis. Praziquental is effective for paragonimiasis.