热带病与寄生虫学 ›› 2025, Vol. 23 ›› Issue (5): 310-312,318.

• 病例报道 • 上一篇    下一篇

智力障碍患者鞭虫重度感染1例

张春山1,武晓丽2,武健1   

  1. 1. 沂水县人民医院,山东 临沂 276400;2. 沂水县疾病预防控制中心
  • 收稿日期:2025-02-25 出版日期:2025-10-20 发布日期:2025-11-28
  • 作者简介:张春山,男,主管技师,硕士在读,研究方向:临床检验诊断。E-mail: 136386609@qq.com

Severe whipworm infection in a patient with intellectual disability

ZHANG Chunshan1, WU Xiaoli2, WU Jian   

  1. 1. Yishui County People’s Hospital, Linyi 276400, Shandong Province, China; 2. Yishui County Center for Disease Control and Prevention
  • Received:2025-02-25 Online:2025-10-20 Published:2025-11-28

摘要: 报道1例智力障碍患者鞭虫重度感染的诊疗过程,为特殊人群土源性寄生虫感染的临床诊疗提供参考。患者因间断腹泻、便血8月余入院,入院初次实验室检查示轻度贫血,嗜酸性粒细胞正常,粪便呈黏液血便、虫卵阴性(后复核为阳性);肠镜检查见结肠壁有大量鞭虫寄生。予甲苯达唑200 mg/次、2次/d,口服治疗3 d后,病情未见明显好转;遂予甲苯达唑400 mg/次、2次/d口服治疗,连用5 d后症状明显好转,复检粪便常规未见虫卵,肠镜未见虫体。4个月后随访患者,其粪便鞭虫虫卵阳性,再次口服甲苯达唑驱虫治疗,同时给予患者个人卫生护理、更换其居住环境,未见再次感染。

关键词: 鞭虫病, 智力障碍患者, 复发, 治疗

Abstract: This article reports the diagnosis and treatment process of severe whipworm infection in a patient with intellectual disability to provide a reference for the clinical diagnosis and treatment of soil-transmitted helminth infections in special population group. The patient was admitted due to intermittent diarrhea and bloody stools for over eight months. Initial laboratory tests upon admission showed mild anemia, normal eosinophil levels, and mucoid bloody stools with negative results for worm eggs (later reviewed as positive). Colonoscopy revealed a large number of whipworms parasitizing the colonic wall. The patient was treated with mebendazole 200 mg twice daily for three days, which led to no significant improvement. However, the symptoms were significantly improved following medication with mebendazole 400 mg twice daily for five days. Follow-up stool examination showed no worm eggs, and colonoscopy revealed no parasites. Four months later, during follow-up, the patient presented with positive whipworm eggs. After successful deworming with another course of mebendazole as well as provision of personal hygiene care for the patient and the living environment being changed, no re-infection occurred. 

Key words: Trichuriasis, Patients with intellectual disability, Recurrence, Treatment

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