Clinical features and misdiagnosis analysis of children with cerebral paragonimiasis with intracranial hemorrhage as initial symptom
10.3760/cma.j.issn.2095-428X.2017.10.013
- VernacularTitle:以颅内出血为首发症状的儿童肺吸虫脑病临床特点及误诊分析
- Author:
Meiying HUANG
;
Xingxu WANG
;
Maoqiang TIAN
;
Juan LI
;
Gaofeng ZHANG
;
Xiaomei SHU
- Keywords:
Cerebral paragonimiasis;
Intracranial hemorrhage;
Misdiagnosis;
Child
- From:
Chinese Journal of Applied Clinical Pediatrics
2017;32(10):767-770
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical characteristics and the cause of misdiagnosis of child suffering from cerebral parago-nimiasis with intracranial hemorrhage as initial symptom,and to improve the diagnosis and treatment level of cerebral paragonimiasis.Methods The clinical data of the children who suffered from cerebral paragonimiasis with intracranial hemorrhage as initial symptom were collected from January 2011 to December 2015 in Affiliated Hospital of Zunyi Medical College.The clinical manifestation,imageology and laboratory tests,outcome of therapy were analyzed and then the effect of treatment and the prognosis were followed up.Results There were 7 patients meeting the inclusion criteria for cerebral paragonimiasis,including 4 male and 3 female.They were from 6 to 13 years old with the average age of 9.3 years old.All patients presented with headache and vomiting,and showed intracranial hemorrhage through CT or MRI of brain.All of the 7 patients were misdiagnosed as cerebrovascular malformation by the neurosurgeons.Three of them showed typical imaging pattern including tunnel sign and the ring-like shape of cerebral paragonimiasis.Five of these cases were attacked by pulmonary distomiasis at the same time.Six of them had an increasing eosinophil,and the paragonimus antibody was positive.They were treated with Praziquantel.Six patients recovered completely,and 1 patient had the dysfunction of left extremities.Conclusions The childhood cerebral paragonimiasis has strong clinical heterogeneity and diversity in manifestation.Intracranial hemorrhage may be the initial symptom,which should be paid more attention to.Cerebral paragonimiasis can be diagnosed and treated early according to the clinical characteristics,the increase of eosinophil,the typical changes in imageology and the specific antibody test.
