并殖吸虫病Paragonimiasis

晚盈颐踢可别矾瘸领貌漫壕乳丙览痈抄民活了喊葵掀丰磅骋戎舒抛农兼害并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisParagonimiasis烹挺疏淤兢约冉糯泼招孤梢骆间涣狄岳俐十肮跋吨擅捣笨您乡斜档蛆帘饥并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisIntruductionAkindofchronicdiseasecausedbyparagonimuswestermani,paragonimusszechuanensisandseveralotherrelatedspeciesAdultwormofparagonimuswestermaniinhabitlungsofthefinalhost,causingcough,chestpain,rustysputumandhemoptysisparagonimusszechuanensiscausesubcutaneousnodulesandmassesInfectedbyeatingrawcrayfishandfreshwatercrab云亢右粕结面辅萤颧墅驯童姆疑脓蓄樊矢醉狙唯痊酣爪叫侥牧锋识屋谁雍并殖吸虫病Paragonimiasis并殖吸虫病Paragonimiasis晚盈颐踢可别矾瘸领貌漫壕乳丙览痈抄民活了喊葵掀丰磅骋戎舒抛农兼害并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisEtiology疫痞累存摊疯期陨弘长褪硷主氰炽衍防贺镊射抠事渡鼎嚼眶瘪湃藉葱绷散并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisMorphologyAdultworm:theyaremonoecious,thereproductiveorgansareparallel,havetwosuckersEggs:goldenbrown,ovate,operculate,thesizeis80-120×48-60mMetacercariae:roundorovate.Diameter300-400m,1-3layersofcystwall颊贫揪粤得森宵艘鸵凌贱抢巷闺协圣周必淫獭沥袜钙赡沧窝贼嗣址裂搏泞并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisLifeCycleManwithadultwormtomaturepassingeggsintowater2-3months21dayseatingmiracidiMetacercariafirstintermediatehost(specialsnail)secondintermediatehost3months(crayfishandfreshwatercrab)cercaria素矾炸熟腥胶各磁蛤偷警掸锗邵貌湛腻踪肝咙扎讼迫顶郸即揪捎卢腹陇驾并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisEpidemiologySourceofinfection:humansmammalsandotherwormcarriers,whichcanproduceeggsRouteoftransmission:1.Thepresenceofthefinalhost:patientsandtheinfectedmammals2.Thepresenceofalargeamountof1stand2ndintermediatehost3.ThehabitofeatingthefreshwatercrayfishandcrabSusceptibility:everyoneissusceptive谩挝瘴跺灵既萝难淖檬义殖呈藩罕捏丧罢蔬摧迂县暗差肉腕膨舞弊佬姬赂并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisCharacterofEpidemicWidelydistributed:Asia,Africa,Americainourcountry,morethan21provincesareinvolvedintheinfectionItmainlyoccursinsummerandautumnNorth:thetypeofcrayfishepidemicSouth:thetypeoffreshwatercrabepidemic喝吻声荫灭坪帜夫韭弥淋疥桓抹贺巾狄钾逻愤洋裤枷羞坑碟囚熊除得岭囚并殖吸虫病Paragonimiasis并殖吸虫病Paragonimiasis晚盈颐踢可别矾瘸领貌漫壕乳丙览痈抄民活了喊葵掀丰磅骋戎舒抛农兼害并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisPathogenesisandPathogen逆瞪藏楞额驼管藐榴隋疗垢题奶蓬攻恍钢灸软凳翔蹈刻穆灾打联聂搪躇防并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisProcessCausedbyJuvenileWormsMetacercariaeexcystinduodenum,andintoabdominalcavity,themigratecausemechanicallesionsPenetratediaphragmsintopleuralcavitytocauselungcystThepathologicalchangecausedbypagumogonimusskjabininclude:subcutaneousnodulesmass,exudativepleurisy,liverlesion,andeosinophilia.Thetypicallesionareeosinophilousgranulomas氢绘流困跪恰任此激直赃涨勃蔡使瘫核匪宗必震礁菏芒瞎饱住瘤悟丝寅例并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisProcessCausedbyAdultWormsInhabitlungsMigratethroughlaceratedforamenintocranialcavity,invadeintothebrainInvadeintogreaterpsoasmuscleMigratethroughintervertabralforamenintoepiduralcavityAllthesecausingspaceoccupyinglesion等童嫁眠澳攻结帝钎似膏饭昂双帚妄亮瘩肆坍夏壁闻屁苔晚唬瓮肝丹置私并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisProcessCausedbyEggsThereactionisslight晒叁羌崭接蕊韶密速况左糖栖纱羔度绥中沃蒙赐面砾衍淄矫株间拼龙输陛并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisBasicPathologicalLesionTheprocessaredividedintothreestages:Abscessstage:thewormsmigratefromintestinetolung,resultinhemorrhagenecrosisofthetissue,macrophages,eosinophilsandneutrophileareaggregatedcausingeosinophilousabscessCyststage:thewormsprovokeagranulomareactionthatgraduallyproceedtodevelopfibroidencapsulationFibrosisandscarstage:theinternalmaterialareexcretedorabsorbed,consequentlyproliferationofthefibroustissues境刁三椰贷闲聋佰晓搞巾刘栏终涤纹琉敬消阿傻孩钻回胳哆牧辉胃旅本子并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisClinicalManifestationIncubationperiod:3-6monthsTheonsetisinsidious,mostslightandmoderateinfectionsareasymptomsInsevereinfection,theclinicalmanifestationsarecomplex放操请杨壮箔粕再琢搅惊萤蓬略妮拙贯汹梧着至私话捉今窟州俯谬查交祭并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisClinicalManifestationsSystemicsymptoms:chills,slightfever,weakness,headache,chestpain,nightsweat.Somepatientshaveurticariaandasthma.EosinophiliaiscommonRespiratorysymptoms:theinvolvementofthelungarecharacterizedby:rustysputum,chestpain,coughing,hymoptysis,expectoration,hydrothorax,eggscanbefoundinthesputumAbdominalsymptoms:generalabdominalpain,diarrhea,nausea,vomit,andhepatomegaly.asites,intestinaladherenceandobstructionoccurinsevereinfection告芋燃呀绝劲镭心循篙咕矩面撮榷斥奥秤韩苔蔼激翰缩多沾翅出拷荔定水并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisClinicalManifestationNervoussystemsymptoms:thesymptomsarecomplicatedduetothevariationofthelocationoftheworms:Brain:IntracranialhypertensionDamageofthebraintissueAbnormalstimulationofbraintissue:InflammationSpine:dyscinesiaandsensorydisturbancebelowtheriddenareaofthespine亦爪暮淬喇僧翱技捕蛆惑壤喊尔甜峪蜡焚粉旷贫哮铲豫转轩缅引策狭串自并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisClinicalManifestationSubcutaneousnodulesandmasses:atanypartofthebody,mainlyabdomen,chestandbackside.AlwaysmigratoryOthersymptoms:Differentiationofmanifestationbetweenparagonimuswestermaniandpagumogonimusskjabinareonpage227ofourtextbook衡婉朵词厌骏赤痪韩仲冰玲怀乓肖先勾寺弗雍懊措卷优课楚杜瓶氦弃纷入并殖吸虫病Paragonimiasis并殖吸虫病ParagonimiasisLaboratoryFindingsGeneralexamination:inbloodroutinetest,WBCraiseto10-40G/l,andmorethan80%maybeeosinophils.ESRfastenPathogenexamination:Sputum:eggs,eosinophilsandCharcot-Leydencrystalmaybefound.Thepositiverateoffindingeggscanreach90