高龄挪威疥确诊患者临床诊治1例

doi:10.20199/j.issn.1672-2302.2024.05.011

热带病与寄生虫学 ›› 2024, Vol. 22 ›› Issue (5): 311-314.doi: 10.20199/j.issn.1672-2302.2024.05.011

高龄挪威疥确诊患者临床诊治1例

王碧柏(), 刘蓬欣, 张玉超, 徐莉, 张中琼, 吴建华, 周志()

通用医疗成飞医院，四川成都610031

收稿日期:2024-03-28 出版日期:2024-10-20 发布日期:2024-11-15
通信作者: 周志, E-mail: 732068773@qq.com
作者简介:王碧柏，女，本科，副主任医师，研究方向：老年医学。E-mail: 372607307@qq.com

Clinical diagnosis and treatment of an elderly patient with confirmed Norwegian scabies

WANG Bibai(), LIU Pengxin, ZHANG Yuchao, XU Li, ZHANG Zhongqiong, WU Jianhua, ZHOU Zhi()

Genertec Medical Chengfei Hospital, Chengdu 610031, Sichuan Province, China

Received:2024-03-28 Online:2024-10-20 Published:2024-11-15
Contact: ZHOU Zhi, E-mail: 732068773@qq.com

摘要/Abstract

摘要：

本文报道1例阿尔茨海默病合并类天疱疮后感染挪威疥（又称结痂型疥疮）的诊断和治疗过程。该患者因“肺部感染”入院，经抗炎治疗后，外周血嗜酸性粒细胞、C反应蛋白、降钙素原仍反复升高；后出现全身多发性斑丘疹及皮肤痂壳，天疱疮与大庖性类天疱疮多项检测阴性，皮屑细菌涂片查见疥螨及虫卵遂确诊为挪威疥，序贯外用10%硫软膏、精联肤康抑菌液（5%二氯苯醚菊酯溶液）配合口服伊维菌素片后，病原学检查确认治愈。密切接触者外用10%硫软膏1个疗程后均痊愈。本病例报道旨在分析老年挪威疥患者的临床诊疗要点。

关键词: 疥螨, 挪威疥, 结痂型疥疮, 高龄患者, 临床诊治

Abstract:

This article reports the diagnosis and treatment process of a case of Alzheimer′s disease complicated with pemphigus vulgaris and infected with Norwegian scabies (also known as scabies scabies). The patient was admitted to the hospital due to pulmonary infection, and after anti-inflammatory treatment, peripheral blood eosinophils, C-reactive protein and procalcitonin rised repeatedly. Afterwards, multiple papules and skin crusts appeared throughout the body, and multiple tests were negative for pemphigus vulgaris and bullous pemphigus vulgaris. Scabies mites and eggs were found on the bacterial smear of the skin flakes, which confirmed the diagnosis of Norwegian scabies. After sequential application of 10% sulfur ointment, Jinglian Fukang antibacterial solution (5% permethrin solution) and oral administration of ivermectin tablets, the patient was cured via pathogen confirmation, and the close contacts were also cured after one course of topical application of 10% sulfur ointment. The purpose of report of this case is to analyze the clinical key points and experience in Norwegian scabies in elderly patients.

Key words: Scabies mites, Norwegian scabies, Crusted scabies, Elderly patients, Clinical diagnosis and treatment

中图分类号:

R757.1

王碧柏, 刘蓬欣, 张玉超, 徐莉, 张中琼, 吴建华, 周志. 高龄挪威疥确诊患者临床诊治1例[J]. 热带病与寄生虫学, 2024, 22(5): 311-314.

WANG Bibai, LIU Pengxin, ZHANG Yuchao, XU Li, ZHANG Zhongqiong, WU Jianhua, ZHOU Zhi. Clinical diagnosis and treatment of an elderly patient with confirmed Norwegian scabies[J]. Journal of Tropical Diseases and Parasitology, 2024, 22(5): 311-314.

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参考文献 17

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检查日期	血红蛋白（g/L）	白细胞计数（×10⁹/L）	中性粒细胞计数（×10⁹/L）	淋巴细胞计数（10⁹/L）	嗜酸性粒细胞计数（×10⁹/L）	单核细胞计数（×10⁹/L）	C反应蛋白（mg/L）	降钙素原（ng/mL）
2023年5月14日	120.0	6.5	5.5	0.8	0	0.3	4.7	0.409
2023年5月18日	107.0	7.9	4.9	2.2	0.1	0.6	1.0	未化验
2023年6月20日	99.0	12.3	9.5	1.1	0.8	0.8	1.3	未化验
2023年7月07日	98.0	19.8	18.7	0.8	0.1	0.2	91.4	0.502
2023年7月25日	98.0	12.3	10.1	1.2	0.6	0.5	2.6	0.610
2023年8月11日	98.0	8.7	5.8	2.1	0.2	0.3	2.8	未化验
2023年9月12日	98.0	9.3	6.3	2.3	0.1	0.6	12.7	0.212
2023年9月25日	105.0	8.6	4.6	3.2	0.1	0.7	0.2	未化验

高龄挪威疥确诊患者临床诊治1例

Clinical diagnosis and treatment of an elderly patient with confirmed Norwegian scabies

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