目的了解2023年贵州省从江县人群土源性线虫感染现状,为该县土源性线虫病防控提供科学依据。方法将从江县按不同地理方位划分5个片区,各片区分别随机抽取1个乡(镇)的1个行政村作为调查点,每个调查点随机整群抽取200名近3个月未驱虫的常...目的了解2023年贵州省从江县人群土源性线虫感染现状,为该县土源性线虫病防控提供科学依据。方法将从江县按不同地理方位划分5个片区,各片区分别随机抽取1个乡(镇)的1个行政村作为调查点,每个调查点随机整群抽取200名近3个月未驱虫的常住居民作为调查对象。2023年采集调查对象粪便标本,采用改良加藤厚涂片法(1粪2检)检测虫卵,比较不同特征人群土源性线虫感染状况。根据每克粪便虫卵数(eggs per gram,EPG),将感染状况分为轻、中、重度感染并计算各类感染构成比。此外,采用问卷调查了解调查对象基本情况及家庭无害化厕所建设情况。结果共调查从江县5个调查点1001名调查对象,土源性线虫感染率为19.08%(191/1001);其中蛔虫、钩虫感染率分别为2.30%(23/1001)、1.90%(19/1001),均为轻度感染;蛲虫感染率为0.10%(1/1001);鞭虫感染率为15.78%(158/1001)。各调查村鞭虫感染率差异有统计学意义(χ^(2)=123.345,P<0.001),其中留架村鞭虫感染率最高(39.00%),其次为龙江村(18.00%);各年龄组人群鞭虫感染率差异有统计学意义(χ^(2)=166.050,P<0.001),其中10~19岁组最高(48.19%),其次是70岁以上组(14.53%)和50~59岁组(13.04%);各职业人群鞭虫感染率差异有统计学意义(χ^(2)=74.134,P<0.001),以中学生感染率最高(32.32%),其次是工人(民工)(10.34%)和农民(10.12%);不同文化程度人群鞭虫感染率差异有统计学意义(χ^(2)=28.761,P<0.001),以小学文化程度者最高(21.60%),其次为文盲(12.03%);不同民族人群鞭虫感染率差异有统计学意义(χ^(2)=42.193,P<0.001)。鞭虫轻、中、重度感染者构成比分别为76.58%(121/158)、14.56%(23/158)和3.16%(5/158),重度感染者均为小学生。在123户家庭中发现鞭虫感染者,其中27户(21.95%)家庭中有2名及以上家庭成员感染。问卷调查共收集有效问卷1001份,家中是、否建有无害化厕所者鞭虫感染率分别为14.69%(139/964)、34.55%(19/55),差异有统计学意义(χ^(2)=15.410,P<0.001)。结论2023年贵州省从江县人群土源性线虫感染率较高,其中鞭虫感染尤为严重,应将小学生、中老年农民、民工作为重点人群开展防控工作。展开更多
BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause...BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause high misdiagnosis and missed diagnosis rates.CASE SUMMARY A 20-year-old male developed persistent neck and back pain after consuming raw snail meat,followed by urinary retention and low fever.After admission,the patient was misdiagnosed as viral infection and Mycobacterium tuberculosis in central nervous system.After detection of Angiostrongylus cantonensis in blood and cerebrospinal fluid by metagenomics next generation sequencing,albendazole was administered with ceftriaxone and methylprednisolone treatment simultaneously.With effective antiparasitic treatment,the patient weaned from mechanical ventilation successfully and transferred out of intensive care unit for hyperbaric oxygen and rehabilitation treatment.CONCLUSION This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.展开更多
Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of thes...Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of these cases are attributed to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hookworm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmission dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identification in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),including hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occurrence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can undermine current MDA and proposed animal deworming-based control efforts.展开更多
BACKGROUND This case highlights the importance of a multidisciplinary approach in differentiating localized infections from systemic inflammatory diseases like psoriatic arthritis.Nail psoriasis can mimic conditions l...BACKGROUND This case highlights the importance of a multidisciplinary approach in differentiating localized infections from systemic inflammatory diseases like psoriatic arthritis.Nail psoriasis can mimic conditions like paronychia,complicating diagnosis.We wrote this report to emphasize the need for clinical vigilance when interpreting imaging findings,especially in patients with a family history of psoriasis.Misdiagnosis can lead to unnecessary systemic treatments,underscoring the significance of dermatological input in achieving accurate diagnoses.CASE SUMMARY A 56-year-old woman presented with redness and swelling of multiple fingertips.Her family history of psoriasis raised suspicion of psoriatic arthritis.Two rheumatologists diagnosed psoriatic arthritis based on ultrasound findings of enthesitis with a positive Doppler signal and recommended methotrexate.However,she was reluctant to initiate therapy due to potential side effects.At our Rheumatology Center,paronychia was suspected,and laboratory tests excluded systemic inflammatory arthritis.Dermatological examination confirmed paronychia,and treatment with fluconazole and ceftriaxone was initiated to address suspected mixed bacterial and fungal infections.Imaging studies,including hand and wrist X-rays,showed no erosions or other signs of psoriatic arthritis.The patient responded well to antimicrobial therapy,with resolution of symptoms.This case highlights the need for thorough clinical evaluation,careful interpretation of imaging findings,and collaboration between rheumatologists and dermatologists to avoid misdiagnosis and inappropriate treatment.CONCLUSION This case underscores the need for thorough clinical evaluation and caution in interpreting nonspecific imaging findings,especially in patients with a family history of psoriasis.While familial predisposition may raise suspicion for psoriatic arthritis,it is essential to integrate laboratory data,imaging studies,and clinical presentation,including response to targeted antimicrobial therapy.A multidisciplinary approach,involving both rheumatologists and dermatologists,is crucial to preventing misdiagnosis,ensuring appropriate treatment,and avoiding the potential harms of unwarranted therapies.展开更多
文摘目的了解2023年贵州省从江县人群土源性线虫感染现状,为该县土源性线虫病防控提供科学依据。方法将从江县按不同地理方位划分5个片区,各片区分别随机抽取1个乡(镇)的1个行政村作为调查点,每个调查点随机整群抽取200名近3个月未驱虫的常住居民作为调查对象。2023年采集调查对象粪便标本,采用改良加藤厚涂片法(1粪2检)检测虫卵,比较不同特征人群土源性线虫感染状况。根据每克粪便虫卵数(eggs per gram,EPG),将感染状况分为轻、中、重度感染并计算各类感染构成比。此外,采用问卷调查了解调查对象基本情况及家庭无害化厕所建设情况。结果共调查从江县5个调查点1001名调查对象,土源性线虫感染率为19.08%(191/1001);其中蛔虫、钩虫感染率分别为2.30%(23/1001)、1.90%(19/1001),均为轻度感染;蛲虫感染率为0.10%(1/1001);鞭虫感染率为15.78%(158/1001)。各调查村鞭虫感染率差异有统计学意义(χ^(2)=123.345,P<0.001),其中留架村鞭虫感染率最高(39.00%),其次为龙江村(18.00%);各年龄组人群鞭虫感染率差异有统计学意义(χ^(2)=166.050,P<0.001),其中10~19岁组最高(48.19%),其次是70岁以上组(14.53%)和50~59岁组(13.04%);各职业人群鞭虫感染率差异有统计学意义(χ^(2)=74.134,P<0.001),以中学生感染率最高(32.32%),其次是工人(民工)(10.34%)和农民(10.12%);不同文化程度人群鞭虫感染率差异有统计学意义(χ^(2)=28.761,P<0.001),以小学文化程度者最高(21.60%),其次为文盲(12.03%);不同民族人群鞭虫感染率差异有统计学意义(χ^(2)=42.193,P<0.001)。鞭虫轻、中、重度感染者构成比分别为76.58%(121/158)、14.56%(23/158)和3.16%(5/158),重度感染者均为小学生。在123户家庭中发现鞭虫感染者,其中27户(21.95%)家庭中有2名及以上家庭成员感染。问卷调查共收集有效问卷1001份,家中是、否建有无害化厕所者鞭虫感染率分别为14.69%(139/964)、34.55%(19/55),差异有统计学意义(χ^(2)=15.410,P<0.001)。结论2023年贵州省从江县人群土源性线虫感染率较高,其中鞭虫感染尤为严重,应将小学生、中老年农民、民工作为重点人群开展防控工作。
基金Supported by the Hainan Provincial Natural Science Foundation of China,No.824MS173 and No.823MS165the Project of Hainan Province Clinical Medical Center.
文摘BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause high misdiagnosis and missed diagnosis rates.CASE SUMMARY A 20-year-old male developed persistent neck and back pain after consuming raw snail meat,followed by urinary retention and low fever.After admission,the patient was misdiagnosed as viral infection and Mycobacterium tuberculosis in central nervous system.After detection of Angiostrongylus cantonensis in blood and cerebrospinal fluid by metagenomics next generation sequencing,albendazole was administered with ceftriaxone and methylprednisolone treatment simultaneously.With effective antiparasitic treatment,the patient weaned from mechanical ventilation successfully and transferred out of intensive care unit for hyperbaric oxygen and rehabilitation treatment.CONCLUSION This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.
基金supported by a Postgraduate Study Support Grant from the Faculty of Medicine,Khon Kaen University.
文摘Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of these cases are attributed to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hookworm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmission dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identification in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),including hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occurrence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can undermine current MDA and proposed animal deworming-based control efforts.
文摘BACKGROUND This case highlights the importance of a multidisciplinary approach in differentiating localized infections from systemic inflammatory diseases like psoriatic arthritis.Nail psoriasis can mimic conditions like paronychia,complicating diagnosis.We wrote this report to emphasize the need for clinical vigilance when interpreting imaging findings,especially in patients with a family history of psoriasis.Misdiagnosis can lead to unnecessary systemic treatments,underscoring the significance of dermatological input in achieving accurate diagnoses.CASE SUMMARY A 56-year-old woman presented with redness and swelling of multiple fingertips.Her family history of psoriasis raised suspicion of psoriatic arthritis.Two rheumatologists diagnosed psoriatic arthritis based on ultrasound findings of enthesitis with a positive Doppler signal and recommended methotrexate.However,she was reluctant to initiate therapy due to potential side effects.At our Rheumatology Center,paronychia was suspected,and laboratory tests excluded systemic inflammatory arthritis.Dermatological examination confirmed paronychia,and treatment with fluconazole and ceftriaxone was initiated to address suspected mixed bacterial and fungal infections.Imaging studies,including hand and wrist X-rays,showed no erosions or other signs of psoriatic arthritis.The patient responded well to antimicrobial therapy,with resolution of symptoms.This case highlights the need for thorough clinical evaluation,careful interpretation of imaging findings,and collaboration between rheumatologists and dermatologists to avoid misdiagnosis and inappropriate treatment.CONCLUSION This case underscores the need for thorough clinical evaluation and caution in interpreting nonspecific imaging findings,especially in patients with a family history of psoriasis.While familial predisposition may raise suspicion for psoriatic arthritis,it is essential to integrate laboratory data,imaging studies,and clinical presentation,including response to targeted antimicrobial therapy.A multidisciplinary approach,involving both rheumatologists and dermatologists,is crucial to preventing misdiagnosis,ensuring appropriate treatment,and avoiding the potential harms of unwarranted therapies.
