返国旅行者血吸虫病和片山综合征的实验室诊断。

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2014-08-01 Epub Date: 2014-06-10 DOI:10.1179/2295333714Y.0000000039
B Van Meensel, E Van Wijngaerden, J Verhaegen, W E Peetermans, M L Lontie, C Ripert
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引用次数: 5

摘要

血吸虫病实验室诊断的金标准是粪便或尿液中存在典型的卵。对返国旅行者的血吸虫病和片山综合征进行实验室诊断是困难的,因为排出的虫卵数量往往非常有限。在早期感染和仅少量接触受污染水的患者中,寄生虫、迁徙幼虫或血吸虫和成虫的总数非常低。只有在粪便或尿液中至少有一对成虫时,才能在最终位置找到卵。寄生虫的数量随着与受感染的水接触次数的增加而增加。污染和产蛋之间的确切潜伏期尚不清楚。据估计,40-50天后开始排卵。早期血吸虫病和片山热的具体诊断主要依靠血清学检测,最好是PCR(如果有的话)。在血吸虫病的早期阶段,这些检测比典型虫卵的显微镜检查灵敏得多(可达4倍)。嗜酸性粒细胞增多(有时超过50%)常出现在急性血吸虫病(片山热)患者中,但在该病的晚期纤维化表现中可能有限或不存在。
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Laboratory diagnosis of schistosomiasis and Katayama syndrome in returning travellers.

The gold standard for laboratory diagnosis of schistosomiasis is the presence of typical eggs in stool or urine. The laboratory diagnosis of schistosomiasis and Katayama syndrome in returning travellers is difficult because the number of excreted eggs is often very limited. In early infections and in patients with only a few contacts with contaminated water, the total number of parasites, migrating larvae or schistosomulae, and adult worms, is very low. Eggs can only be found in faeces or urine when there is at least one pair of adult worms at the final location. The number of parasites increases as a function of the number of contacts with infected water. The exact latency between contamination and egg production is unknown. It is estimated that excretion of eggs starts after 40-50 days. The specific diagnosis of early schistosomiasis and Katayama fever relies essentially on serologic tests or preferably on PCR (if available). These assays are much more sensitive (up to four times) in the early phase of schistosomiasis than microscopic examination for typical eggs. Eosinophilia (sometimes exceeding 50%) is often present in patients with acute schistosomiasis (Katayama fever), but may be limited or absent in late fibrotic manifestations of the disease.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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