[一例输入性非洲锥虫病的病原鉴定]。

Yi Sun, Wei-hua Huang, Zi-guang Niu, Hui Wang, Jie Guo, Xiao-xia Hu, Jing-long Yu, Dao-yin Zhou, Ya-li Weng, An-mei Deng
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引用次数: 0

摘要

目的:对一例输入性非洲人锥虫病进行实验室诊断并鉴定病原。方法:收集临床和流行病学资料。采集血液和脑脊液样本,进行赖特-吉姆萨染色,并进行显微镜检查。用特异的引物扩增血液样本的基因组DNA,分别针对锥虫表达位点相关基因(ESAG)、布氏锥虫冈比亚锥虫特异性糖蛋白(TgsGP)和18S rRNA(M18S-Ⅱ- tb)基因和布氏锥虫罗得西亚锥虫特异性血清抗性相关基因(SRA)。同时进行全血细胞计数、血液化学和脑脊液检查。结果:患者有下肢无力、表面淋巴结肿大4个月的病史。体格检查显示嗜睡,偶有情绪异常,伴贫血(血红蛋白85 g/L),电解质紊乱(钠124 mmol/L;氯87 mmol/L),非特异性免疫球蛋白(球蛋白63 g/L)显著升高。流行病学调查显示,该患者在非洲加蓬共和国工作期间多次遭受昆虫叮咬和蜇伤。显微镜检查发现外周血有锥虫鞭毛。PCR扩增得到ESAG、TgsGP和M18S-Ⅱ- tb特异性引物的条带分别为286、308和150 bp。结论:综合临床资料、流行病学史、病因学及PCR结果,诊断为布氏冈比亚锥虫感染。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Pathogen Identification for An Imported Case with African Trypanosomiasis].

Objective: To perform laboratory diagnosis for an imported case of human African trypanosomiasis and identify the pathogen.

Methods: Clinical and epidemiological information was collected. Blood and cerebrospinal fluid samples were collected, stained with Wright-Giemsa, and microscopically examined. Genomic DNA from the blood samples was amplified with primers specific for Trypanosoma sp. expression site-associated gene (ESAG), Trypanosoma brucei gambiense specific glycoprotein (TgsGP) and 18S rRNA(M18S-Ⅱ-Tb) gene, and Trypanosoma brucei rhodesiense specific serum resistance associated (SRA) gene. Complete blood count, blood chemistry, and CSF examination were also conducted.

Results: The patient had a 4-month history of lower extremity weakness and swelling of surface lymph nodes. Physical examination showed somnolence, and occasional emotional abnormalities, accompanied by anemia (hemoglobin 85 g/L), electrolyte disturbance (sodium 124 mmol/L; chlorine 87 mmol/L) and significantly increased nonspecific immune globulin protein (globulin 63 g/L). Epidemiological survey showed that the patient suffered insect bites and stings for several times during his work in the Republic of Gabon in Africa. Microscopic examination revealed flagella of trypanosome in peripheral blood. PCR amplification produced bands of 286, 308, and 150 bp with primers specific for ESAG, TgsGP and M18S-Ⅱ-Tb, respectively.

Conclusion: The patient was diagnosed with Trypanosoma brucei gambiense infection from the clinical information, epidemiological history, etiology and PCR results.

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