切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (05) : 646 -649. doi: 10.3877/cma.j.issn.1673-5250.2013.05.017

所属专题: 经典病例 文献

论著

儿童皮肤蝇蛆病1例及文献复习
陶于洪1,*,*(), 王亚妹1   
  1. 1. 610041 四川成都,四川大学华西第二医院儿科
  • 收稿日期:2013-08-01 修回日期:2013-09-05 出版日期:2013-10-01
  • 通信作者: 陶于洪

Case Report of Children Cutaneous Myiasis and Review of the Literatures

Yu-hong TAO1(), Ya-mei WANG1   

  1. 1. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2013-08-01 Revised:2013-09-05 Published:2013-10-01
  • Corresponding author: Yu-hong TAO
  • About author:
    (Corresponding author: TAO Yu-hong, Email: )
引用本文:

陶于洪, 王亚妹. 儿童皮肤蝇蛆病1例及文献复习[J/OL]. 中华妇幼临床医学杂志(电子版), 2013, 09(05): 646-649.

Yu-hong TAO, Ya-mei WANG. Case Report of Children Cutaneous Myiasis and Review of the Literatures[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2013, 09(05): 646-649.

目的

提高对皮肤蝇蛆病的认识。

方法

选择本院2012年10月收治的1例儿童皮肤蝇蛆病患儿为研究对象(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会的批准,征得受试对象监护人的知情同意,并与家属签署临床研究知情同意书)。复习1999年1月至2013年8月我国其他医院报道的98例皮肤蝇蛆病,总结本病的流行病学、临床表现和诊治方法。

结果

本例患儿为6岁,男孩,临床表现为发热、肌肉疼痛、多发性皮下结节、虫体钻出后的皮肤损害、镜下血尿、嗜酸粒细胞增多和左侧少量胸腔积液,在皮肤破损周围诱导出蝇蛆,经鉴定为牛皮蝇,给予口服甲苯达唑片治疗3 d出院。出院2周后随访结果显示痊愈。从相关文献检索搜集的98例皮肤蝇蛆病可见,皮肤蝇蛆病发病率仅次于眼蝇蛆病,主要致病蝇种为牛皮蝇和纹皮蝇;好发于畜牧区,主要高发地为四川省西北地区,其次为青海省;以儿童多见。发热、游走性疼痛性皮下结节、嗜酸粒细胞增多和虫体钻出后的皮肤损害是皮肤蝇蛆病的典型表现,可并发心脏、肺、胃肠道和大脑等其他内脏器官病变。不典型患者可被误诊为结核性胸膜炎、丹毒、风湿性关节炎、荨麻疹和腮腺炎等其他疾病。检出蝇蛆是确诊本病的主要依据。皮肤蝇蛆病无特异性治疗,多采用去除蝇蛆和对症治疗。阿苯达唑片、氯喹片或甲硝唑片等驱虫剂用于治疗有内脏器官损害患者。

结论

皮肤蝇蛆病多见于儿童。对不明原因发热、游走性疼痛性皮下结节、嗜酸粒细胞增多和有虫体钻出的皮肤损害患者,应考虑皮肤蝇蛆病。诊断皮肤蝇蛆病主要依据为检出蝇蛆,该病无特异性治疗方法。

Objective

Cutaneous myiasis is skin infestation by the larvae (maggots) of certain fly species.The aim of this study is to acquire more knowledge about cutaneous myiasis.

Methods

One case of children cutaneous myiasis in this hospital was reported. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of West China Second University Hospital, Sichuan University. Informed consent was obtained from the parents of this child. 98 cases of cutaneous myiasis reported by other domestic hospitals from January 1999 to August 2013 were reviewed. The epidemiology, clinical manifestation, diagnostic methods and treatment of cutaneous myiasis were analyzed and summarized.

Results

A six-year-old boy presented with fever, myalgia, multiple painful subcutaneous node, skin lesions, microscopic hematuria, eosinophilia and left pleural effusion. Maggot lured by honey was identified as Hypoderma bovis. And this boy was orally treated with mebendazole tablet for three days and fully recovered two weeks later. The domestic document showed that cutaneous myiasis was second only to ocular myiasis and most of the infected were children. Main pathogens of cutaneous myiasis were Hypoderma bovis and Hypoderma lineatum. Cutaneous myiasis mainly distributed at pastoral areas, especially in the northwest of Sichuan province, next in Qinghai province. Typical clinical manifestation included fever, migratory painful hypodermic nodule, eosinophilia and skin lesions. Cutaneous myiasis was complicated by visceral lesions.The organ involved included heart, lung, gut and brain. Atypical cutaneous myiasis was misdiagnosed as other diseases such as tuberculous pleurisy, erysipelas, rheumatoid arthritis, urticaria, and mumps. Diagnosis of cutaneous myiasis was made after finding maggot. Treatment was non-specific and consisted of extraction of larva and symptomatic treatment. Oral helminthicide such as albendazole tablet, chloroquine tablet, or metronidazole tablet was applied when visceral lesions occured.

Conclusions

Most of the cutaneous myiasis patients are children. Cutaneous myiasis should be considered in patients with fever of undetermined origin, migratory painful hypodermic nodule, eosinophilia or skin lesions drilled by maggot. Diagnosis of cutaneous myiasis is mainly based on finding maggot. Treatment of cutaneous myiasis is non-specific.

图1 患儿腹股沟皮肤破损
Figure 1 Skin lesions at inguen
图2 蝇蛆虫体
Figure 2 Body of maggot
图3 蝇蛆头咽骨(盐酸卡红染色,×200)
Figure 3 Head pharyngeal bone of maggot(hydrochloric card red staining,×200)
图4 蝇蛆后气门(盐酸卡红染色,×200)
Figure 4 Post stigma of maggot (hydrochloric card red staining,×200)
1
Jiang CP, Xue CL.Comprehensive analysis of 107 cases of human myiasis from 1995 to 2002[J].Chin J Parasitol Parasit Dis,2003,21(1):55-56.
2
Xiao GG, Deng JJ, Liao L,et al. One Case of children myiasis[J]. Chin J Pediatr, 2010,48(9):719.
3
Chen XN. A case with cutaneous myiasis caused by gasterophilus nigricornis[J]. Chin J Parasitol Parasit Dis,2001,19(1):60.
4
Feng PY, Huang HQ, Zhang XH, et al. Case report: Furuncular cutaneous myiasis caused in a worker returning from Africa[J].Southern China J Derm Venereol, 2009,16(4):265-267.
5
Liu F, Wang WJ, Lu SJ, et al. A first case report of cutaneous myiasis due to cordylobia anthropophaga in China and reviews of related references[J]. Chin J Derm Venereol,2010,24(3):221-223.
6
Qiu YL. Two cases of anopheles tumbu fly myiasis[J]. Chin J Parasitol Parasit Dis,2011,29(2):76.
7
Robbins K, Khachemoune A. Cutaneous myiasis: A review of the common types of myiasis[J]. Int J Dermatol,2010,49(10):1092-1098.
8
Liu XH. One case of children myiasis with eosinophilic pneumonia[J]. Chin J Parasitol Parasit Dis,2010,28(2):107.
9
Jiang XS, Huang XF, Song YJ, et al. The epidemiological investigation and control of hypodermiasis on the northwest grassland in Sichuan province of China[J].Chin J Vet Sci Tech,2002,32(10):16-19.
10
Zhang XW, Xue ZL, Zhao Q. One case of a large area of head wound infected by maggots[J].Chin J Misdiagn,2008,8(28):7046-7047.
11
Xie PY, Liu P. Three cases of children myiasis[J]. Acta Parasitol Med Infect Dis,2010,8(4):227.
12
Ma ZH. Lesson from misdiagnosis of cutaneous myiasis due to careless physical examination:Case report of cutaneous myiasis[J].New Chin Med, 2008,39(9):610.
13
Liu XH. One case of children myiasis concurrent eosinophilic pneumonia[J]. Chin J Parasitol Parasit Dis,2010,28(2):107.
14
Zhang C, She JS, Zhang WQ. One case of cutaneous myiasis with pleural effusion as the first manifestation[J]. Guide Chin Med,2011,(17):299.
15
Wei XJ. One case of cutaneous myiasis associated with empyema[J]. Chin J Parasitol Parasit Dis,2002,20(1):7.
16
Wang Y, Tao ZB, Wang J, et al. One child with heart damage caused by cutaneous myiasis[J].J Pediatr Tradit Chin Med,2008,4(3):39.
17
Wang YQ. One case of purulent meningitis caused by myiasis[J]. Clin Focus,2009,24(15):1369.
[1] 陶宏宇, 叶菁菁, 俞劲, 杨秀珍, 钱晶晶, 徐彬, 徐玮泽, 舒强. 右心声学造影在儿童右向左分流相关疾病中的评估价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 959-965.
[2] 刘琴, 刘瀚旻, 谢亮. 基质金属蛋白酶在儿童哮喘发生机制中作用的研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 564-568.
[3] 向韵, 卢游, 杨凡. 全氟及多氟烷基化合物暴露与儿童肥胖症相关性研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 569-574.
[4] 张梦思, 麻艺群, 蒙礼娟, 朱辉, 付晋凤. 压力手套与指蹼加压带及泡沫型硅凝胶贴膜联合应用于儿童瘢痕性并指术后的效果观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(04): 329-334.
[5] 刘静, 王燕妮, 王继萍. 儿童毛发移植应用前景及病例讨论[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(04): 368-368.
[6] 郑宝英, 黄小兰, 贾楠, 朱春梅. 儿童难治性肺炎支原体肺炎早期预警指标[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(04): 215-221.
[7] 刘冉佳, 崔向丽, 周效竹, 曲伟, 朱志军. 儿童肝移植受者健康相关生存质量评价的荟萃分析[J/OL]. 中华移植杂志(电子版), 2024, 18(05): 302-309.
[8] 丁荷蓓, 王珣, 陈为国. 七氟烷吸入麻醉与异丙酚静脉麻醉在儿童腹股沟斜疝手术中的应用比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 570-574.
[9] 曾纪晓, 徐晓钢, 王欣星, 刘斐, 兰梦龙, 陶波圆, 梁子建, 叶志华, 罗媛圆. 达芬奇机器人辅助Swenson-like巨结肠根治术[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(04): 239-243.
[10] 中华医学会器官移植学分会, 中华医学会外科学分会外科手术学学组, 中华医学会外科学分会移植学组, 华南劈离式肝移植联盟. 劈离式供肝儿童肝移植中国临床操作指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 593-601.
[11] 刘军, 丘文静, 孙方昊, 李松盈, 易述红, 傅斌生, 杨扬, 罗慧. 在体与离体劈离式肝移植在儿童肝移植中的应用比较[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 688-693.
[12] 张琛, 秦鸣, 董娟, 陈玉龙. 超声检查对儿童肠扭转缺血性改变的诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 565-568.
[13] 王晓瑜, 郭群英, 牛雅萌, 赵成松. 公立儿童医院促进儿科就医均等化实践探析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(04): 383-387.
[14] 陈晓胜, 何佳, 刘方, 吴蕊, 杨海涛, 樊晓寒. 直立倾斜试验诱发31 秒心脏停搏的植入心脏起搏器儿童一例并文献复习[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 488-494.
[15] 曹亚丽, 高雨萌, 张英谦, 李博, 杜军保, 金红芳. 儿童坐位不耐受的临床进展[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 510-515.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?