vaginal schistosomiasis
Introduction
Introduction to vaginal schistosomiasis Vaginal schistosomiasis (schistosomiasisofvagina) is caused by the cercariae cercariae passing through the skin into the blood. When the adult enters the pelvic venous plexus from the portal system, it can infect the vulva, vagina and cervix. In addition, vaginal infection of the bladder can affect 1/3 of the cervix and vagina. After puberty, schistosomiasis occurs in the lower genital tract, and adults are more common in the fallopian tubes, ovaries, and uterus. basic knowledge The proportion of illness: 0.0035% Susceptible people: women Mode of infection: fecal-mouth transmission Complications: human papillomavirus infection
Cause
Causes of vaginal schistosomiasis
(1) Causes of the disease
It is usually infected by the skin mucous membrane contacting the infected water containing the cercariae cercariae.
(two) pathogenesis
The schistosomiasis sputum gland secretes toxins, causing an acute inflammatory reaction. A large number of cells gather around the eggs, and the central part of the cell infiltration often undergoes necrosis, causing local formation of eosinophilic abscesses, followed by mucosal rupture, sometimes seeing fistulas in the perineum. Most sinus can make the lesion form a special honeycomb appearance, and can also cause granulomatous genital warts of schistosomiasis. The cervix can cause pseudoepithelial neoplasia in the squamous epithelium, and scars, ulcers and calcifications are formed in the lesions.
Prevention
Prevention of vaginal schistosomiasis
Personal protection: Avoid or reduce direct contact with contaminated water. Applying 15% butyl phthalate emulsion and anti-mite oil to the skin 10 minutes before the epidemic area is launched, the tail scorpion can be prevented from drilling into the skin and can be applied for 4 hours. Use protective equipment or drugs to prevent the cercaria from invading the body. Wear protective gloves, long-lasting rubber shoes, and nylon protective pants.
Group protection: water body mites in susceptible areas, strengthen the sanitation treatment of drinking water in residents' temporary residences, add 0.5g of bleaching essence or 1g of bleaching powder per 50kg of drinking water, and drink after 30min. Reduce the wading operation by improving the production method; or use tools instead of artificial water when working on the water, use waterproof clothing, etc., and reform the production tools. Strengthen key population monitoring and management of people from epidemic areas: people who enter the infectious snail fishing, grazing, water transportation and flood fighting during the epidemic season and the temporary levees on the embankment in the flood season should be registered and recorded. In particular, foreign water operators in non-endemic areas should be urged to do their own personal protection, make records and distribute drugs to ensure that they do not develop acute infections. For the first time in contact with the infected water for about 4 weeks, praziquantel was given at a dose of 40 mg/kg, or early prevention was given with artemether or artesunate 2 weeks after exposure to the infected water at the peak of infection.
The most fundamental way to prevent schistosomiasis is to eliminate snails. The snail-killing snail can adopt the physical snail-killing method such as soil burial, ditch hardening, sorghum seed, water storage culture and fire burning snail. It can also adopt the method of snail killing, immersion and other drugs, and can also use snails through Xinglin snail and the like. Natural enemies or other creatures directly destroy or destroy their population balance and achieve the purpose of snail control.
Complication
Vaginal schistosomiasis complications Complications Human papillomavirus infection
Human papillomavirus, human immunodeficiency virus infection.
Symptom
Symptoms of vaginal schistosomiasis Common symptoms Sexual intercourse difficulties Dysmenorrhea increased menstrual flow Multiple sexual intercourse pain
Irregular vaginal bleeding, menorrhagia and dysmenorrhea, vaginal discharge increased significantly, vaginal swelling and discomfort, there are papules and sand-like plaques, which can be connected into a patch, showing polypoid or papillary hyperplasia, sometimes forming ulcers and scars, causing sexual intercourse Difficulties, painful intercourse, bleeding after sexual intercourse and a large amount of vaginal secretions, the cervix, uterus, fallopian tubes can also be involved, the thick spots on the mucosa are sand-like, followed by calcification.
Examine
Examination of vaginal schistosomiasis
1. The relative and absolute counts of blood eosinophils can be significantly increased.
2. Parasitological examination can be found in the urine and stool can be found in the tail of the thorns or calcified eggs; for sigmoidoscopy, take the intestinal mucosa tablets to check the eggs, if necessary, local biopsy.
3. Vaginal secretions can also detect eggs. By detecting eosinophil cationic protein (ECP) in vaginal secretions, IgA can assist in the diagnosis of female genital schistosomiasis.
4. Immunological examination can assist diagnosis, including intradermal test, delayed type hypersensitivity skin test, rosette formation test, lymphocyte transformation test or complement fixation test, etc., detection of immune function and ring egg sedimentation test, enzyme standard convection method, Enzyme-linked immunosorbent assay (ELISA) detects specific IgG, IgM and IgA or indirect hemagglutination tests to detect antibodies, and the positive rate is high, but beware of sometimes false positives.
5. PCR (polymerase chain reaction) examination of human papillomavirus.
6. HIV antibody detection, qualitative detection of HIV nucleic acid, quantitative determination of HIV RNA.
No abnormal performance.
Diagnosis
Diagnosis and identification of vaginal schistosomiasis
Biopsy see multiple inflammatory infiltrates, small abscesses or non-necrotic pseudotuberculous nodules, surrounded by lymphocytes, neutrophils, plasma cells, eosinophils, granulation and foreign bodies The epithelial cell response of giant cells can be diagnosed by finding schistosomiasis in venous blood.
Be careful to identify with other chronic inflammations such as amebiasis, cancer, and condyloma acuminata.
