每日一题_2024.10.18

A 2-year-old boy from a rural village was brought to the pediatric clinic with a 6-month history of diarrhea and poor weight gain. His body weight was 12.1 kg (below the 25th percentile for his age) and height 90 cm (1 SD below the median for his age). Physical examination revealed dry mucous membranes and decreased skin turgor. Laboratory tests showed iron-deficiency anemia, eosinophilia, and occult blood in the stool. Stool samples examined by direct microscopy for ova and parasites were negative. A colonoscopy showed numerous mobile, white worms adherent to the colon wall. What is the most likely culprit organism?

一个来自农村村庄的2岁男孩因为6个月的腹泻和体重增长不良被带到儿科诊所。他的体重是12.1公斤（低于他这个年龄的第25百分位数），身高90厘米（低于他这个年龄的中位数1个标准差）。体格检查发现粘膜干燥和皮肤弹性减退。实验室检查显示缺铁性贫血、嗜酸性粒细胞增多，以及粪便中的隐血。通过直接显微镜检查粪便样本中的虫卵和寄生虫结果为阴性。结肠镜检查显示结肠壁上附着着许多活动的白色蠕虫。最有可能的病原体是：

A. Ascaris lumbricoides蛔虫

B. Enterobius vermicularis (pinworm)蛲虫（Enterobius vermicularis，蠕形住肠线虫）

C. Hymenolepis nana (dwarf tapeworm)微小膜壳绦虫（Hymenolepis nana，侏儒绦虫）

D. Strongyloides stercoralis粪类圆线虫（Strongyloides stercoralis）

E. Trichuris trichiura (whipworm)鞭虫（Trichuris trichiura，毛圆线虫）

答案解析：

经鉴定为Trichuris trichiura。他们诊断出了滴虫病——也被称为人类鞭虫感染。鞭虫病是由摄入被鞭虫卵污染的土壤引起的。成虫在大肠中成熟，并穿过粘膜附着在那里。滴虫病通常无症状，但在严重感染的情况下，可能导致腹泻和生长迟缓，特别是在幼儿中。

正确答案：E