Clonorchiasis sinensis, also known as clonorchiasis, is a disease caused by the Chinese liver fluke (Clonorchis sinensis) infecting the human liver and bile ducts. It is widely distributed in China, particularly in regions where the consumption of raw or undercooked fish is common, with Guangdong being the most affected area. Mild cases may be asymptomatic, while severe cases can lead to digestive dysfunction and biliary cirrhosis. In children with severe infections, it may cause growth and developmental disorders.

bubble_chart Clinical Manifestations

1. Most infants are asymptomatic, and the infection is only discovered when worm eggs are found during stool examination.
2. Older children may experience loss of appetite, abdominal pain, diarrhea, and hepatomegaly.
3. Severe cases may present with emaciation, anemia, developmental delays, and even symptoms of cirrhosis, such as jaundice, hematochezia, ascites, and vitamin A deficiency.

bubble_chart Auxiliary Examination

1. Peripheral blood eosinophilia.
2. Detection of early-stage eggs in direct fecal smears or sediment concentration methods can confirm the diagnosis.
3. Duodenal drainage to search for eggs in gallbladder bile or duodenal aspirate.
4. Finding eggs in liver biopsy tissue or identifying adult worms in the bile ducts during surgery.
5. The positive rate of antigen intradermal testing is high, but attention must be paid to distinguishing false positives caused by schistosomiasis or paragonimiasis.
6. Serological tests such as indirect fluorescent antibody and counterimmunoelectrophoresis can aid in diagnosis.

bubble_chart Diagnosis

Epidemiological history of residing in endemic areas with a history of consuming raw freshwater fish and shrimp.

(1) General Therapy

Enhance nutrition, correct anemia, and provide liver protection treatment. If there is secondary biliary tract infection, antibacterial therapy should be administered. Deworming can be performed after the condition improves.

(2) Pathogenic Treatment

1. Praziquantel is the drug of choice for this disease. The dose is 25mg/kg each time, three times a day, taken for one day. The fecal negative conversion rate can reach 80% to 100%.
2. Furapromide is administered to children at 60mg/(kg·d), divided into three oral doses, with a 14-day course of treatment. Side effects include loss of appetite, nausea, vomiting, abdominal pain, diarrhea, hematochezia, and spasms. For severe reactions, the dose should be halved or discontinued.
3. Bithionol (Bitin) is given to children at 50mg/(kg·d), divided into three oral doses, with a course of 20 to 30 consecutive days.
4. Chloroquine is administered to children at 10mg/(kg·d), divided into three oral doses, with a course of 6 to 8 weeks.

bubble_chart Prevention

1. Strengthen health education. Change the habit of eating raw fish and shrimp.
2. Thoroughly treat patients.
3. Enhance fecal management.