并殖吸虫病Paragonimiappt课件

单击此处编辑母版标题样式,并殖吸虫病Paragonimia,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,Paragonimiasis,并殖吸虫病Paragonimia,1,Paragonimiasis并殖吸虫病Paragonimia,Intruduction,A kind of chronic disease caused by,paragonimus westermani,paragonimus szechuanensis,and several other related species,Adult worm of,paragonimus westermani,inhabit lungs of the final host, causing cough, chest pain, rusty sputum and hemoptysis,paragonimus szechuanensis,cause subcutaneous nodules and masses,Infected by eating raw crayfish and freshwater crab,并殖吸虫病Paragonimia,2,IntruductionA kind of chronic,Etiology,并殖吸虫病Paragonimia,3,Etiology并殖吸虫病Paragonimia3,Morphology,Adult worm:,they are monoecious, the reproductive organs are parallel, have two suckers,Eggs:,golden brown, ovate, operculate, the size is 80-120,48-60,m,Metacercariae:,round or ovate. Diameter 300-400 m, 1-3 layers of cyst wall,并殖吸虫病Paragonimia,4,MorphologyAdult worm: they are,Life Cycle,Man with adult worm,to mature passing eggs into water,2-3months 21 days,eating miracidi,Metacercaria,first intermediate,host(special snail),second intermediate host 3 months,(crayfish and freshwater crab,),cercaria,并殖吸虫病Paragonimia,5,Life CycleMan with adult worm,Epidemiology,Source of infection:,humans mammals and other worm carriers, which can produce eggs,Route of transmission:,1.The presence of the final host:patients and the infected mammals,2.The presence of a large amount of 1,st,and 2,nd,intermediate host,3.The habit of eating the freshwater crayfish and crab,Susceptibility:,every one is susceptive,并殖吸虫病Paragonimia,6,EpidemiologySource of infectio,Character of Epidemic,Widely distributed: Asia, Africa, America in our country, more than 21 provinces are involved in the infection,It mainly occurs in summer and autumn,North:the type of crayfish epidemic,South:the type of freshwater crab epidemic,并殖吸虫病Paragonimia,7,Character of EpidemicWidely di,Pathogenesis and Pathogen,并殖吸虫病Paragonimia,8,Pathogenesis and Pathogen并殖吸虫病,Process Caused by Juvenile Worms,Metacercariae excyst in duodenum, and into abdominal cavity, the migrate cause mechanical lesions,Penetrate diaphragms into pleural cavity to cause lung cyst,The pathological change caused by,pagumogonimus skjabin,include :subcutaneous nodules mass, exudative pleurisy , liver lesion, and eosinophilia. The typical lesion are eosinophilous granulomas,并殖吸虫病Paragonimia,9,Process Caused by Juvenile Wor,Process Caused by Adult Worms,Inhabit lungs,Migrate through lacerated foramen into cranial cavity, invade into the brain,Invade into greater psoas muscle,Migrate through intervertabral foramen into epidural cavity,All these causing space occupying lesion,并殖吸虫病Paragonimia,10,Process Caused by Adult WormsI,Process Caused by Eggs,The reaction is slight,并殖吸虫病Paragonimia,11,Process Caused by EggsThe reac,Basic Pathological Lesion,The process are divided into three stages:,Abscess stage:,the worms migrate from intestine to lung, result in hemorrhage necrosis of the tissue, macrophages, eosinophils and neutrophile are aggregated causing eosinophilous abscess,Cyst stage:,the worms provoke a granuloma reaction that gradually proceed to develop fibroid encapsulation,Fibrosis and scar stage:,the internal material are excreted or absorbed, consequently proliferation of the fibrous tissues,并殖吸虫病Paragonimia,12,Basic Pathological LesionThe p,Clinical Manifestation,Incubation period: 3-6 months,The onset is insidious, most slight and moderate infections are asymptoms,In severe infection, the clinical manifestations are complex,并殖吸虫病Paragonimia,13,Clinical Manifestation Incubat,Clinical Manifestations,Systemic symptoms:,chills, slight fever, weakness, headache, chest pain, night sweat. Some patients have urticaria and asthma. Eosinophilia is common,Respiratory symptoms:,the involvement of the lung are characterized by: rusty sputum, chest pain, coughing, hymoptysis, expectoration, hydrothorax, eggs can be found in the sputum,Abdominal symptoms:,general abdominal pain, diarrhea, nausea, vomit, and hepatomegaly.asites, intestinal adherence and obstruction occur in severe infection,并殖吸虫病Paragonimia,14,Clinical ManifestationsSystemi,Clinical Manifestation,Nervous system symptoms:,the symptoms are complicated due to the variation of the location of the worms:,Brain: Intracranial hypertension,Damage of the brain tissue,Abnormal stimulation of brain tissue:,Inflammation,Spine: dyscinesia and sensory disturbance below the ridden area of the spine,并殖吸虫病Paragonimia,15,Clinical Manifestation Nervous,Clinical Manifestation,Subcutaneous nodules and masses:,at any part of the body, mainly abdomen, chest and backside. Always migratory,Other symptoms:,Differentiation of manifestation between,paragonimus westermani,and,pagumogonimus skjabin,are on page 227 of our textbook,并殖吸虫病Paragonimia,16,Clinical ManifestationSubcutan,Laboratory Findings,General examination:,in blood routine test, WBC raise to 10-40 G/l, and more than 80% may be eosinophils. ESR fasten,Pathogen examination:,Sputum:,eggs, eosinophils and Charcot-Leyden crystal may be found. The positive rate of finding eggs can reach 90%,Stool:,the eggs come from sputum swallowed, the positive rate is 15-40%,Biopsy of subcutaneous nodules and masses:,typical eosinophilous granuloma with eggs, larvae and adult worm,并殖吸虫病Paragonimia,17,Laboratory FindingsGeneral exa,Laboratory Findings,Immunological test:,Intracutaneous test,ELISA,Dot-ELISA and Weston blot,IHA and RIA etc.,X-ray,Chest examination:,CT,Brain vascular and spine photography,并殖吸虫病Paragonimia,18,Laboratory FindingsImmunologic,Diagnosis,Epidemiologic date:,history of eating raw or pickled freshwater crab or crayfish,Clinical manifestation:,cough, rusty sputum,migratory subcutaneous nodules and masses,epilepsy, headache and paralysis,Laboratory findings:,Finding eggs or worms,Immunological test,并殖吸虫病Paragonimia,19,DiagnosisEpidemiologic date:并殖,Differential Diagnosis,Tuberculosis : tubercular pleurisy or peritonitis,Brain tumor and other brain parasitosis,Viral hepatitis,并殖吸虫病Paragonimia,20,Differential DiagnosisTubercu,Prognosis,Because the species, the location and the degree of infection are different, the prognosis is difference.,The prognosis are usually good,The prognosis of cerebrospinal type is bad,并殖吸虫病Paragonimia,21,PrognosisBecause the species,Treatment,并殖吸虫病Paragonimia,22,Treatment并殖吸虫病Paragonimia22,Pathogen Treatment,Praziquantel,is the best choice of drug for the therapy of paragonimiasis,Dose:25mg/kg, three times a day, for 2-3 days, the brain type need 2 times therapy, the interval is 7 days,The other drugs for choice include:,mebendazole,:efficient for,p.skijabini,bithionol,并殖吸虫病Paragonimia,23,Pathogen TreatmentPraziquantel,Heteropathy Treatment,Cough, chest pain: antitussive, analgestics,Epilepsy: valium or luminal,Intracranial hypertension: dehydrating agent,Space occupying lesion: surgery operation,并殖吸虫病Paragonimia,24,Heteropathy TreatmentCough, ch,Prevention,Control of the source of infection:,Treat the patients and domestic animal at the same time.,Cut off the route of transmission:,并殖吸虫病Paragonimia,25,Prevention Control of the sour,