Taenia mansoni and sporocystosis in children
Introduction
Introduction to pediatric Manchurian tsutsugamushi disease and Mann's rickets Mann's tsutsugamushi disease and sparganosis mansoni are diseases caused by adult spirometramansoni parasitic in the human small intestine and Mann's schistosomiasis. basic knowledge The proportion of illness: 0.0025% Susceptible people: children Mode of infection: digestive tract spread Complications: vitreous opacity corneal ulcer glaucoma coma
Cause
Pediatric Mann's tsutsugamushi disease and the cause of Man's schizophrenia
(1) Causes of the disease
The adult is 60-100cm long and the head section is 1~1.5mm long. It has a finger shape, and the back and the ventral surface each have a longitudinal suction groove. The chain body is composed of about 1000 segments. The eggs are oval and the ends are slightly pointed. (52 ~ 76) m × (31 ~ 44) m, light gray-brown, thin egg shell, egg cover at one end, egg cells and multiple yolk cells in the egg, split-head long band, white, about 300mm long , without sections, but with irregular horizontal pleats, there is a clear depression in the center of the front end of the worm body.
The development of A. sinensis is the same as that of the broad-striped aphid. The main source of infection is cats and dogs. The first intermediate host is Jianshui, and the second intermediate host is frog, snake, bird and pig. Continued host, human can be used as the second intermediate host of A. sinensis, and then transferred to the host or even the final host.
(two) pathogenesis
1. Mang's tsutsugamushi adult worm is only accidentally parasitic in the human body, its virulence to humans is not strong, may only have middle, upper abdominal discomfort, mild abdominal pain, nausea, vomiting and other gastrointestinal symptoms.
2. The common parasitic parts of the mites in the human body are: the eyes, the limbs of the limbs, the oral and maxillofacial organs and the internal organs, forming eosinophilic granuloma sacs in the parts of the mites and mistletoe, and even forming abscesses, cysts, One or several lobes are in the sac, and the wall of the sac is fibrous connective tissue. There may be white chyle-like or bean slag-like exudate and Charcotic crystallization in the sac. There are inflammatory cells such as eosinophils around the sac. Infiltration, schistosomiasis mainly has the following types: invading eyes caused by phlegm and phlegm, causing ocular rickets, subcutaneous schizophrenia, oral and maxillofacial rickets, cerebral schizophrenia, visceral rickets, proliferative rickets.
Prevention
Pediatric Mania tsutsugamushi and Mann's rickets prevention
Do not drink raw water, do not eat raw or uncooked frog meat, snake meat or pork, do not use frog meat, snake meat paste to cure.
Complication
Complications of pediatric Manchurian tsutsugamushi and Mann's rickets Complications vitreous opacity corneal ulcer glaucoma coma
The rickets can form abscesses, ocular rickets can cause uveitis, vitreous opacity, corneal ulcers, and even blindness caused by secondary cataracts. If the worm invades the anterior chamber of the eye, it causes anterior chamber empyema, iris adhesion, secondary glaucoma, Vision is severely diminished until blindness, and cerebral schizophrenia can cause blurred vision, convulsions, coma, and hemiplegia. The visceral rickets cause abdominal mass, peritonitis, and even intestinal perforation. Proliferative schizophrenia can cause patients to lose weight and collapse.
Symptom
Pediatric Mann's tsutsugamushi disease and Mann's schizophrenia symptoms Common symptoms Atrophic keratitis Inflammatory cell infiltration, tears, light, abdominal pain, uveitis, eyeball, peritonitis, nausea
Adults accidentally parasitic in the human body caused by Manchurian tsutsugamushi disease, only mild abdominal pain, nausea, vomiting and other gastrointestinal symptoms.
The incubation period of schizophrenia is different, and the harm to humans is much larger than that of adult worms. The tissue is swollen in the part of the mites and mistletoe, which can form abscesses with a diameter of 1 to 6 cm. There are 1 or several lobes in the sac. The incubation period varies from a few days to a year or even longer. The main types of rickets are as follows:
1. ocular rickets: This type is more common, patients with eyelid swelling, bulbar conjunctival congestion and edema, photophobia, tearing, slight pain, itching or worm crawling; some patients with nausea, vomiting and fever, redness and swelling It can be touched by induration, redness and hard joints can often be displaced, so it can be expressed in the orbital or conjunctival downstream dynamic strips or masses. The invasion of the phlegm can also cause eyelids, conjunctiva and corneal inflammation, such as the rapid escape of the rupture of the head. If it invades the eyeball or invades the anterior chamber of the eye, it can cause various complications such as uveitis, anterior chamber empyema, until blindness, parasitic in the eyelids, and there may be eyeballs and movement disorders.
2. Subcutaneous cleft rickets: About 1/3 of the total number of patients, mainly in the chest wall, neck, breast, abdominal wall, external genitalia and limbs subcutaneous, such as the migratory subcutaneous nodules, nodules can be round, strip Cable-like, columnar or irregular, varying in size, 0.5 to 5 cm long, non-adhesive to the skin, local itching or insect crawling. If there is inflammation, it may appear red, swollen, painful or tender, or urticaria. When the lesion is enlarged, white worms sometimes climb out, and subcutaneous schizophrenia sometimes mistakes the tumor.
3. Oral and maxillofacial rickets: About 1/5 to 1/4 of the total number of patients, manifested as subcutaneous induration in the oral mucosa, neck, behind the ears or cheeks, the size is about 0.5 ~ 3cm, the affected area is red and swollen Itching or insect crawling; often there are cracks that escape from the mass.
4. Cerebral schizophrenia: About 2.3% of the total number of patients, tissue sections can be seen in the brain tissue cysts, inflammatory exudate and worm body cut surface, or tunnel formation, inflammatory cell infiltration, sac The wall is granulomatous, clinical manifestations resemble brain tumors, paroxysmal headaches, blurred vision, intermittent sputum twitching, limb numbness, severe ejaculation, convulsions, coma, and hemiplegia.
5. Visceral schizophrenia: This type is less, accounting for only 1% of the total number of patients. The clinical symptoms and the degree of harm to the patient depend on the migration and parasitic parts of the hiatus, such as invading the peritoneum, which can be parasitic in the mesentery and kidney. Around, causing abdominal mass, peritonitis, and even intestinal perforation, the cleft palate in the abdominal cavity can also enter the chest through the diaphragm to invade the lungs. At this time, the worm may be coughed up, parasitic on the spinal cord, spinal canal, urethra and bladder. Report.
6. Proliferative schizophrenia: The schistosomiasis invades the human body and grows in the buds. The worms are small and irregular, and can be parasitic in the subcutaneous, intestinal wall, mesentery, kidney, heart, lung, brain and other tissues. The tissue is honeycomb-like and nodular, and can cause extensive swelling in the extremities. It seems to be like a skin swelling. The patient is generally weakened, thin and prostration, and the prognosis is poor. The pathogenesis of this mites and its adults are still not certain, such as In this case, the cat or dog can be fed with the live insects detected, and the eggs are seized in the feces after 3 weeks for identification.
Examine
Examination of pediatric Manchurian tsutsugamushi and Mann's rickets
1. Fecal examination: For adult infection of A. sinensis, it can be confirmed by stool examination and the eggs are found.
2. Immunological detection: Immunological detection with a sputum sputum antigen, such as antibody positive can be diagnosed.
3. Biopsy: If suspected of split-head rickets, biopsy of local masses and nodules can be performed, and a diagnosis can be established by detecting the hiatus.
For visceral and cerebral palsy, comprehensive analysis should be performed in combination with CT, X-ray, magnetic resonance imaging and clinical manifestations, medical history, etc. to make a diagnosis.
Diagnosis
Diagnostic identification of pediatric mites and schizophrenia
Ask the history of useful frog meat to apply for treatment or raw frog meat, the history of snake meat; for adult infection, the eggs can be examined by feces; biopsy of local masses and nodules; visceral and cerebral palsy Combined with immunological detection, comprehensive analysis of CT, X-ray, magnetic resonance and other examination results.
Eye rickets should be differentiated from various other causes of eye diseases; subcutaneous schizophrenia must be differentiated from similar lesions caused by cysticercosis and paragonimiasis, and brain rickets should be associated with cerebral cysticercosis, brain paragonimiasis and brain tumors. Identification.
