[Clinical features of imported schistosomiasis mansoni in Beijing City：a report of 6 cases].

OBJECTIVE: To analyze the clinical features of 6 patients with imported schistosomiasis mansoni, including the epidemic history, clinical manifestations, laboratory tests and therapeutic effect, so as to provide references for improving the levels of diagnosis and treatment of physicians. METHODS: The clinical data of 6 patients with imported schistosomiasis mansoni from January 2009 to July 2016 were collected and analyzed. RESULTS: All the 6 imported patients with schistosomiasis mansoni had a clear history of cercarial infested water exposure. The main manifestations were continuous fever and eosinophilia. Three (50%) patients were accompanied with diarrhea. Anti-Schistosoma japonicum IgG antibody were cross positive in 2 (33.3%) patients, while live eggs of S. mansoni were explored in intestinal mucosa specimens of all the patients. CD3+CD8+ T cell ratio was decreased significantly but B cell ratio was elevated in all the patients, and the main immunoglobulin of the patients was IgG. Hydroperitoneum and splenomegaly signs were discovered by abdominal ultrasonography in 16.6% (1/6) of the patients. Multiple liver nodules and wall thickening of rectum and sigmoid colon were revealed by pelvic MR scan in 16.6% (1/6) of the patients. Colitis was found in all the patients, and 66.6% (4/6) of the patients were combined with multiple colonic ulcers by the electronic colonoscopy examination. Chronic inflammation and eosinophil infiltration were found in all the patients by rectum pathology. All 6 patients were cured with chemotherapy named praziquantel. CONCLUSIONS: Comprehensive analysis of clinical data including epidemiological history, specific manifestations, laboratory tests and intestinal mucosa pathology may be benefit of the management of schistosomiasis mansoni.

Screening Pneumocystis carinii pneumonia in non-HIV-infected immunocompromised patients using polymerase chain reaction.

We evaluated the clinical value of polymerase chain reaction (PCR) for screening Pneumocystis carinii pneumonia (PCP) in non-HIV-infected immunocompromised patients. We retrospectively analyzed PCR and Grocott's methenamine silver (GMS) staining on 1044 clinical specimens obtained from 756 patients. Positive rates of PCR and GMS staining in sputum specimens were 21.1% and 9.5%, respectively (P < 0.01), and in bronchoalveolar lavage (BAL), specimens were 31.9% and 25.5%, respectively. Among 5 patient groups, the highest GMS staining and PCR positive rates were observed in immunosuppressed patients. In 28 GMS staining-positive patients, positive rates of PCR and GMS staining after a short anti-PCP treatment were 39.3% and 17.9%, respectively. In 5 patients with positive PCR but negative GMS staining results in initial sputum examination, GMS staining result turned positive in subsequent BAL specimens. In conclusion, PCR is sensitive for detection of Pneumocystis in sputum specimens and is useful for screening PCP in non-HIV-infected high-risk patients.

An epidemiologic study on Pneumocystis pneumonia in non-HIV infected patients in China / 中华流行病学杂志

Objective To analyze the epidemiologic features of Pneumocystis pcumonia (PCP) among non-HIV infected patients in China. Methods Sputum or bronchoalveolar lavage fluid (BALF) specimens obtained from 851 pneumonia patients without HIV infection from Jan. 2006 to Oct. 2008 were detected, using PCR and Gomori' s methenamine silver (GMS) stain for Pneumocystis jirovecii. Results Of the 615 sputum specimens, P.jirovecii positive rates of PCR and GMS stain were 20.3% and 10.2% respectively (P<0.05). Of 236 BALF specimens, P. jirovecii positive rates of PCR and GMS stain were 32.6% and 25.5% respectively (P0.05). Of the total 851 pneumonia cases, 123 (14.5%) were GMS positive for P.jirovecii cyst and 202 cases (23.7%) were PCR positive for P. jirovecii DNA. In those immuno-suppressed patient group including patients with connective tissue diseases, organ transplant recipients, nephrotic, hematologic diseases and malignant tumor, P. jirovecii positive rate appeared the highest, 28.2% for GMS stain and 39.4% for PCR. There were also PCP patients in the immuno-competcnt pneumonia patient groups including senile patients with chronic diseases and patients without clear predisposing immuno-deficiencies. The positive rates of P. jiroveeii GMS were 8.7% and 10.9% , respectively and 17.5% and 19.6% for P. jiroveeii under PCR.Conclusion PCR assay seemed sensitive for the detection of P. jirovecii in the sputum specimens and could be used for screening PCP patients without HIV infection. Our data showed that there was high risk of PCP in non-HIV infected patients in China.