Abstract:

Objective To analyze the clinical, imaging and laboratory features for the atypical Clonorchis sinensis, and reduce misdiagnosis and missed diagnosis of Clonorchis sinensis. Methods Four atypical Clonorchis sinensis cases were analyzed on the epidemiological history, clinical manifestations and laboratory examination, serological and pathogenic detection, and the effect of treatment was evaluated. The clinical and laboratory features for the atypical Clonorchis sinensis were summarized. Results Patients from non-endemic regions with higher level of eosinophilia and lgE should be considered the possibility of parasitic infection. The clinical manifestations reflected in imaging as patchy low density occupying changes in the early stage, which indicated the pathological injury of hepatocyte necrosis, should be excluded the possibility of Clonorchis sinensis infection. The serological and pathogenic diagnosis of Clonorchis sinensis should be perfected, and it could be necessary for the patients with trial anthelmintic treatment. Conclusion The differential diagnosis of Clonorchis sinensis should
be strengthened for the patients from non-endemic regions with higher level of eosinophilia and patchy low density occupying changes in liver by imaging. It was necessary to detect Clonorchis sinensis eggs in feces even if in the trial anthelmintic treatment process, and the rate of misdiagnosis and missed diagnosis of Clonorchis sinensis could be reduced.

Key words: Clonorchis sinensis, Clinical manifestations, Laboratory examination, Imaging