Xu Wang, Aiya Zhu, Hongying Cai, Baixue Liu, Gang Xie, Rui Jiang, Ji Zhang, Nanzi Xie, Yayi Guan, Robert Bergquist, Zhenghuan Wang, Yang Li, Weiping Wu
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引用次数: 3
Abstract
Background: Cystic echinococcosis (CE), caused by the larval stage of the complex Echinococcus granulosus sensu lato (s.l.), is a zoonotic parasitic disease with a high social burden in China. E. ortleppi is a species (formerly genotype 5 of E. granulosus s.l.) with unique epidemic areas (tropical areas), transmission patterns (mainly cattle origin), and pathological characteristics (large and small hook lengths) compared to other species that cause CE. A 19-year-old female patient in an area with no history of echinococcosis in Guizhou Province, China, was diagnosed with E. ortleppi infection in 2019. This study is to understand the source of this human E. ortleppi infection.
Methods: We performed computer tomography (CT) scans, surgical operation, morphological sectioning, molecular diagnosis, phylogenetic analyses, and epidemiological investigation in Anshun City, Guizhou Province, China in 2019.
Results: The patient presented with intermittent distension and pain in the upper abdomen without other abnormal symptoms. Routine blood examination results were normal. However, abdominal CT revealed a fertile cyst with a diameter of approximately 8 cm, uniform density, and a clear boundary, but without an evident cyst wall in the right lobe of the liver. The cyst was fertile, and phylogenetic analyses revealed that the isolates represented a new E. ortleppi genus haplotype. A result of 10‒14 years incubation period with indigenous infection was considered available for the case through the epidemiological survey.
Conclusions: CE due to E. ortleppi infection can be confused with other diseases causing liver cysts, resulting in misdiagnosis. A transmission chain of E. ortleppi may exist or existed in the past in the previously considered non-endemic areas of echinococcosis in southwestern China.
背景:囊性棘球蚴病(CE)是一种由复杂的细粒棘球蚴(Echinococcus granulosus sensu lato, s.l.)幼虫期引起的人畜共患寄生虫病,在中国具有很高的社会负担。与引起CE的其他物种相比,北棘棘球绦虫是一种具有独特流行区域(热带地区)、传播模式(主要来自牛)和病理特征(大钩长度和小钩长度)的物种(原棘球绦虫5基因型)。2019年,贵州省某地区无棘球蚴病史的19岁女患者被诊断为奥特皮埃希菌感染。本研究旨在了解这种人类奥特皮埃希菌感染的来源。方法:对2019年贵州省安顺市患者进行计算机断层扫描、外科手术、形态切片、分子诊断、系统发育分析和流行病学调查。结果:患者表现为间歇性上腹部胀痛,无其他异常症状。血常规检查正常。腹部CT示一肥沃囊肿,直径约8cm,密度均匀,边界清晰,肝右叶未见明显囊肿壁。该囊是可育的,系统发育分析表明,分离物代表了一个新的奥特皮鼠属单倍型。通过流行病学调查,认为该病例的本土感染潜伏期为10-14年。结论:奥氏肠杆菌感染引起的肝囊肿易与其他引起肝囊肿的疾病混淆,导致误诊。中国西南地区棘球蚴病非流行区可能存在或曾经存在过棘球蚴病传播链。
期刊介绍:
Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application.
The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings.
In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.