Paragonimiasis
Introduction
Introduction to paragonimiasis Paragonimiasis is mainly caused by the migration of adult or adult worms in human tissues and organs, mechanical damage caused by colonization, and immunological pathological reactions caused by metabolites. When the human being eats or eats half a raw crab, the cockroach, the prawn, the aquatic insect, the red maiden, etc., which contain the paragonimiasis, can be infected. The first intermediate host of Paragonimus pygmaea is more than 20 species of freshwater snails, and the second intermediate host is crabs, which are crustaceans. The terminal host is a mammal or a mammal such as a cat or a pig. These animals, other than humans, are also called insect-preserving hosts, and are the main source of infection that constitutes a natural foci. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: abscess pleural effusion
Cause
Cause of paragonimiasis
Pathogen infection (95%):
When the human being eats or eats half a raw crab, the cockroach, the prawn, the aquatic insect, the red maiden, etc., which contain the paragonimiasis, can be infected. The pathogenicity of Paragonimus is mainly the migration of adult or adult worms in human tissues and organs, the mechanical damage caused by colonization, and the immunopathological reactions caused by metabolites.
Pathogenesis:
There are nearly 40 species of paragonimus in the world, among which 8 species are pathogenic to human body, mainly Paragonimus sinensis and Paragonimus sichuan. The first intermediate host of Paragonimus pygmaea is more than 20 species of freshwater snails, and the second intermediate host is crabs, which are crustaceans. The terminal host is a mammal or a mammal such as a cat or a pig. These animals, other than humans, are also called insect-preserving hosts, and are the main source of infection that constitutes a natural foci.
Prevention
Paragonimiasis prevention
1. The key to preventing this disease is to prevent stone crabs, cockroaches and raw water that are not raw or half-baked to prevent infection.
2, timely detection and thorough treatment of patients, strengthen investigation and killing of sick animals and sick animals.
3, do not spit, do not go to the stool, prevent the patient's sputum and feces from contaminating the water source, use lime to kill the eggs in the sputum and feces.
4. Once the patient is ill, he should be treated thoroughly.
Complication
Paragonimiasis complications Complications abscess pleural effusion
Common complications are:
1. Abscess, cyst.
2. Brain-type paragonimiasis can be complicated by epilepsy, convulsions, hemiplegia, and movement disorders.
Symptom
Symptoms of paragonimiasis Common symptoms High fever hemoptysis cysts Chest pain Diarrhea Toxic hypothermia Abdominal pain Nausea night sweats
1. The onset is slow, with mild fever, night sweats, fatigue, loss of appetite, cough, chest pain and cough brown red jam.
2. Abdominal pain, diarrhea, nausea, vomiting, tan and thick pus and bloody stools.
3. Allergic symptoms such as urticaria.
4. Acute paragonimiasis has a sharp onset, high fever and toxemia.
5. Low back pain, difficulty in lower limb movement, even paraplegia, difficulty in urinary and bladder, incontinence.
6. pleural fluid accumulation, can be complicated by pleural thickening or empyema.
7. The abdomen can reach cystic masses, mesenteric lymph nodes, liver, spleen, testicles and other swelling and peritoneal effusion.
8. Meningeal irritation, hemianopia, paresthesia or loss, optic nerve head edema.
Examine
Examination of paragonimiasis
Pathogen diagnosis
(1) Examination of cockroaches or faecal eggs: The identification of clostridium eggs can be confirmed.
(2) Biopsy: Subcutaneous mass or nodular surgical removal may reveal child worms, or typical pathological changes.
Immunoassay
(1) Intradermal test: commonly used for census, the positive coincidence rate can be as high as 95% or more, but often there are false positives and false negatives.
(2) Enzyme-linked immunosorbent assay: high sensitivity, positive rate of 90% to 100%.
(3) Circulating antigen detection: The circulating antigen in serum was directly detected by enzyme-linked immunosorbent antigen spot test (AST-ELISA), and the positive rate was above 98%, and it can be used as a therapeutic evaluation.
Diagnosis
Diagnosis and identification of paragonimiasis
diagnosis
1. There is a history of eating unfamiliar stone crabs or sputum in the epidemic area of this disease.
2. Long-term cough, hemoptysis, brown-brown jam-like phlegm, some have low fever, night sweats, less signs of lungs, and signs when combined with pleural effusion. Sichuan paragonimiasis can still be seen in the abdomen, the chest and back, etc. Section or mass.
3. The blood eosinophils are obviously increased. The sputum can be diagnosed by direct smear or 24-hour concentration method. (Sichuan paragonimiasis can not find eggs).
4. X-ray examination: round or elliptical infiltrating shadow with blurred edges in the lungs, single room, multi-atrial cystic shadow, hidden in the lung shadow, change indefinitely, lesions in the middle and lower lung fields are more common , often accompanied by a small amount of pleural effusion.
5. Pneumocystis adult antigen intradermal test, posterior decidual membrane test and (or) paragonimiasis complement binding test positive.
6. Subcutaneous nodules or masses for biopsy, eosinophilic granuloma, and eggs or paragonimiasis larvae can be diagnosed.
7. Brain-type paragonimiasis has neurological symptoms and signs, should be identified with cysticercosis, brain tumors, for cerebrospinal fluid complement test, positive can help diagnose.
The disease should be differentiated from tuberculosis, nodular arteritis, Hodgkin's disease.
