每日一题_2023.07.27

A 13-year-old boy from Mali was referred to the pediatric urology clinic with a 3-month history of gross hematuria. He reported no fevers, flank pain, or dysuria. A physical examination was normal. Laboratory studies showed normal kidney function and an absolute eosinophil count of 2660 per cubic millimeter (reference range, 40-200). A urinalysis showed hematuria and pyuria, and a urine culture was negative. Microsopic examination of the urine is shown. What is the most likely diagnosis?

一名来自马里的13岁男孩因肉眼血尿3个月被转诊至小儿泌尿外科门诊。患者自诉无发热、胁痛或排尿困难。体格检查正常。实验室检查显示肾功能正常，嗜酸性粒细胞绝对计数为2,660 / mm3(参考范围，40 ~ 200 / mm3)。尿液分析显示血尿和脓尿，尿培养结果为阴性。显示尿液的显微镜检查。最有可能的诊断是什么?

A. Balantidium coli 结肠小袋纤毛虫

B. Schistosoma hematobium 埃及血吸虫

C. Schistosoma mansoni 曼氏血吸虫

D. Strongyloides stercoralis 粪类圆线虫

E. Trichomonas vaginalis 阴道毛滴虫

答案解析：

正确答案是埃及血吸虫，一种流行于非洲和中东的寄生虫。尿液镜检示卵圆形、末端棘状寄生虫卵。膀胱活检标本的组织病理学检查显示急性和慢性乳头状和息肉样膀胱炎，无不典型增生。给予吡喹酮治疗，症状在开始治疗后1个月消退。

正确答案：B