Chocolate-colored pus or amoeba found

Introduction Pulmonary pleural amebiasis is generally not difficult to diagnose according to the clinical manifestations and laboratory tests of the medical history, and the pathogen can be diagnosed by sputum or pleural effusion. Lung and pleural amebiasis are pulmonary and pleural suppurative inflammation caused by the infection of amoeba. The hepatic lesions occur mostly in the right lower lung, and the blood-borne lesions are mostly multiple lesions in both lungs. There are more than 10 species of amoeba parasitic in the human body, and only the tissue-producing amoeba is pathogenic to the human body. The trophozoite is a parasitic form of the protozoa that exists in the form of large and small trophozoites and cysts.

Cause

There are more than 10 species of amoeba parasitic in the human body, and only the tissue-producing amoeba is pathogenic to the human body. The trophozoite is a parasitic form of the protozoa that exists in the form of large and small trophozoites and cysts. Large trophozoites are pathogenic, and small trophozoites are intermediate transition types between trophozoites and cysts. Mature cysts are infectious and have strong resistance to external abilities. They survive in feces for more than 2 weeks and survive in water for more than 5 weeks. It is the only form of the disease that spreads the disease. Amibat has a gene encoding a proteolytic enzyme that has an important impact on the ability to invade tissue.

Pathogenesis: In the amoeba infection, 90% of the occult infections occur 10% of invasive amebiasis. This depends mainly on the characteristics of the infected strain and on the host's immune status, nutritional status and resistance. When a person swallows food or water contaminated by cysts, because the capsule has anti-gastric acid action, it reaches the lower part of the small intestine smoothly. With the catalytic action of trypsin, the cystic worms are disintegrated and split into small trophozoites. , settled in the intestine. In the normal function of the colon, the small trophozoites stop moving, secreting the cyst wall to form a cyst, and excreted with the feces. When the host body's resistance is reduced or intestinal dysfunction, small trophozoites invade the intestinal wall and proliferate, transforming into large trophozoites.

The pathogen directly contacts and adheres to the target cells, phagocytizing and dissolving the tissue cells. The trophozoite releases hydrolyzed protease to cause tissue lysis and necrosis and is resistant to complement? It adheres to the neutrophils involved in the body's response, releasing more enzymes to aggravate tissue inflammation and destruction, forming abscess lungs, and chest and abdomen amebiasis 90% Liver-derived health search. It can be penetrated by the liver abscess into the pleura and lung; through the liver, sputum, lung adhesion tissue space, blood vessels invade the lung; through the hepatic vein into the inferior vena cava to the lungs and pleura. Intestinal trophozoites invade the lungs from the intestinal wall lesions through the intestinal lymphatic duct into the superior vena cava or the lower rectal vein into the inferior vena cava.

an examination

Related inspection

Amoeba protozoa antibody amoeba antigen white blood cell classification count

I. History and symptoms

There are often diarrhea or pus and bloody stools. In the acute phase, there are fever, fatigue, night sweats, loss of appetite and other symptoms. There may be cough, sputum, chest pain. Some patients may have blood stasis, hemoptysis or chocolate sputum. If the abscess breaks into the chest, then Severe chest pain and difficulty breathing, even pleural shock.

Second, physical examination found

The respiratory movement on one side of the chest lesion is weakened, and the intercostal space may have tenderness and pain. The local percussion is voiced, the breath sound is weakened or there is rales, and there may be a pleural fluid. Chronic patients may have anemia and clubbing (toe).

3. Auxiliary inspection

(1) White blood cell count and classification: the acute phase increased, and it was more obvious after secondary infection. The white blood cell count and classification of chronic patients can be normal or reduced, and there can be red blood cell reduction and erythrocyte sedimentation rate.

(B) sputum, pleural fluid examination if the amoeba or trophozoites can be diagnosed.

(3) Serological examination: Indirect hemagglutination, indirect fluorescent antibody, enzyme-labeled immunosorbent assay, convective immunoelectrophoresis, etc. are highly sensitive, and negative test results can help to rule out the disease.

(4) X-ray chest examination: more large-scale density increases the shadow, there may be cloud-like infiltration around. After the formation of abscess, the liquid level may appear in the shadow and the irregular abscess wall. Pleural amebiasis is characterized by pleural effusion, pus, or pleural thickening, adhesions and other signs.

(5) Ultrasound examination: It is helpful to diagnose and determine the location and volume of pleural fluid.

Differential diagnosis

Must be identified in bacterial lung abscess, pneumonia, tuberculosis and other types of empyema.

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