Pulmonary-pleural amebiasis
Introduction
Introduction to pulmonary-pleural amebiasis Pulmonary-pleural amebiasis is a lung and pleural suppurative inflammation caused by the infection of amoeba. The hepatic lesions occur mostly in the right lower lung, and the blood-borne lesions are mostly multiple lesions in both lungs. basic knowledge The proportion of sickness: 0.01% - 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: amoebic dysentery amoebic liver abscess
Cause
Lung-pleural amebiasis etiology
Prevention
Pulmonary-pleural amebiasis prevention
The disease is prevalent in the world and is more prevalent in tropical and subtropical regions. However, in the colder regions and even in the Arctic Circle, there are also amoeba infections and epidemics. The infection rate is closely related to local environmental sanitation, economic status and eating habits. It is estimated that about 10% of the world's people are infected, and some local infection rates can be as high as 50%. The distribution in China is generally higher in rural areas than in cities. In recent years, due to the improvement of health status and living standards in China, acute amoeba Cases of dysentery and abscesses, with the exception of individual areas, are relatively rare, mostly in chronically prolonged or typical cases and with worms.
(1) Source of infection:
Chronic patients, convalescent patients and healthy worms are the source of infection for this disease. The encapsulation resistance is very strong. In humid and low temperature environment, it can survive for more than 12 days, and can live for 9 to 30 days in water, but The capsule has weak resistance to dryness, high temperature and chemical drugs. For example, when it is 50 °C, it will die for a short time. The survival time in a dry environment is only a few minutes. In 0.2% hydrochloric acid, 10% to 20% saline and soy sauce, Vinegar and other condiments cannot survive for a long time, and 50% alcohol can kill it quickly.
(2) Ways of transmission:
There are several ways to spread E. histolytica:
1 Encapsulated contaminated water sources can cause outbreaks in the area.
2 In the case of manure as a fertilizer, unwashed and uncooked vegetables are also important transmission factors.
3 cysts contaminate fingers, food or utensils to spread.
4 Both flies and cockroaches can be exposed to feces, carry and vomit feces on the surface, and encapsulate the contaminated food as an important medium of transmission.
(3) Popular characteristics:
The amebic disease in the lytic tissue is widely distributed. In temperate regions, the disease can be prevalent, while in the tropical and subtropical regions, the prevalence is particularly serious. Since the liberation of our country, the infection rate of amoeba has been significantly reduced. For example, Beijing Capital Hospital examined 38 075 cases from 1973 to 1978, with a positive rate of 0.52%; Fujian Medical University in 1976, 216 children in Hui'an, the positive rate was 4.63%; Northeast Jiamu Medical College report (1980), inspection of suburban high school students In 487 cases, the positive rate was only 0.4%; in 1979, a total of 557 large-scale farmers were removed from the Yueqing County, Zhejiang Province, with a positive rate of 3.2%. The incidence of the disease varied from time to time, with more in autumn and second in summer. Females, more adults than children, may be associated with swallowing foods containing cysts or age.
Complication
Pulmonary-pleural amebiasis complications Complications amoebic dysentery amoebic abscess
Can be complicated by amoebic meningoencephalitis, amoebic dysentery, amoebic liver abscess and so on.
Symptom
Pulmonary-pleural amebic disease symptoms Common symptoms Diarrhea, fatigue, night sweats, fever, cough, slightly...
First, medical history and symptoms:
Often have a history of diarrhea or pus and bloody stools, acute fever, fatigue, night sweats, loss of appetite and other symptoms, may have cough, sputum, chest pain, some patients may have blood stasis, hemoptysis or chocolate sputum, such as abscess into the chest, then Severe chest pain and difficulty breathing, even pleural shock.
Second, the physical examination found:
On the side of the chest lesion, the respiratory movement is weakened. The intercostal space may have tenderness, pain, local percussion, dullness, decreased breath sounds or rales, and pleural fluid. Chronic patients may have anemia and clubbing (toe). ).
Examine
Pulmonary-pleural amebiasis
(1) White blood cell count and classification: The acute phase is increased, and it is more obvious after secondary infection. The white blood cell count and classification of chronic patients can be normal or reduced, and there may be red blood cell reduction and erythrocyte sedimentation rate.
(B) , pleural fluid examination if the amoeba or trophozoites can be diagnosed.
(3) Serological examination: indirect hemagglutination, indirect fluorescent antibody, enzyme-labeled immunosorbent assay, convective immunoelectrophoresis, etc., have high sensitivity, and negative test results can help to rule out the disease.
(4) X-ray chest examination: more large-scale density increases the shadow, there may be cloud-like infiltration around. After the formation of the abscess, the liquid level may appear in the shadow and the irregular abscess wall. The pleural amebic disease manifests as pleural effusion, pus pectoral or pleural thickening, adhesion and other signs.
(5) Ultrasound examination: It is helpful to diagnose and determine the location and volume of pleural fluid.
Diagnosis
Diagnosis and identification of pulmonary-pleural amebiasis
Diagnosis based on symptoms and findings.
The disease must be identified in bacterial lung abscess, pneumonia, tuberculosis and other types of empyema.
