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題 名 | 臺灣的陰蝨感染症:陰蝨嚴重感染個案、陰蝨形態與分子鑑定比較與病例文獻回顧=Pthiriasis in Taiwan: A Case of Severe Pthirus pubis Infestation, Comparison of Morphological and Molecular Identification, and Retrospective Clinical Case Series |
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作 者 | 蔡育峰; 李嘉文; 顏采瑩; 吳文哲; 蕭旭峰; 蔡坤憲; | 書刊名 | 臺灣昆蟲 |
卷 期 | 43:1 2023.02[民112.02] |
頁 次 | 頁1-14 |
分類號 | 412.4924 |
關鍵詞 | COI條碼基因; 人陰蝨; 陰蝨感染症; 性傳染病; 立克次體; COI barcode; Pthirus pubis; Pthiriasis; Sexually transmitted disease; Rickettsia; |
語 文 | 中文(Chinese) |
DOI | 10.6662/TESFE.202302_43(1).001 |
中文摘要 | 陰蝨 (=人陰蝨,或稱蟹蝨) (Pthirus pubis (Linnaeus)) 是一種絕對的人體外寄生蟲,主要取 食人體血液以獲得營養,常出現於人體之陰部毛髮和眼瞼部睫毛上,傳染途徑主要透過性行為或親 密接觸。受到陰蝨寄生而有搔癢、過敏與皮膚變色等臨床病徵者,稱之為陰蝨感染症 (pthiriasis)。 本研究描述一例 70 歲老翁陰部嚴重感染陰蝨之臨床個案,並首次以形態鑑定與粒線體基因 COI 分 子鑑定,同步分析 9 位臨床個案陰部之 27 隻陰蝨檢體。個案 70 歲老翁因下體嚴重搔癢就醫,患 者自述有按摩店全套按摩的活動史,臨床上發現陰部毛髮及肛門處毛髮有嚴重陰蝨寄生,數量超過 千隻。分析 9 名個案共計 27 隻陰蝨之形態特徵與 COI 序列顯示完全一致。經 NCBI 資料庫比對, 序列與法國巴黎近郊和美國佛羅里達州二地之陰蝨序列 100%相同 (423 bp)。以 PCR 檢驗陰蝨是 否攜帶致病性立克次體 (Rickettsia spp.) 或不動桿菌 (Acinetobacter spp.),檢驗結果均為陰性。 臺灣偶有特殊陰蝨感染症的文獻報告,共有 8 篇 11 例陰蝨感染症之病例報告,主要就診地區為臺 北、臺中和嘉義,1 例陰部陰蝨感染症,3 例眼瞼部陰蝨感染症,1 例頭髮部陰蝨感染症,1 例寄 生於眼瞼部和頭髮,5 例同時寄生於眼瞼部和陰部。本研究顯示陰蝨感染症在臺灣並未斷絕且被忽 略,未來仍須針對臺灣其他地區建立醫學昆蟲學的基礎知識,以促進公共衛生教育之推動。 |
英文摘要 | The pubic or crab louse, Pthirus pubis (Linnaeus), is a human ectoparasite known to feed on human blood. It most commonly infests pubic hair, causing pthiriasis pubis, and occasionally infests eyelashes, causing pthiriasis palpebrarum. The primary transmission route of pubic louse is through sexual or intimate contact. Pthiriasis often manifests clinically with symptoms such as pruritus, allergic reactions, and post-inflammatory hyperpigmentation. We present a case of Pt. pubis hyperinfestation and compare molecular identification using Pt. pubis specimens collected from the pubic regions of nine patients. A 70-year-old man presented to the clinic, complaining of severe pruritus in the pubic region, following a full-body massage. More than a thousand Pt. pubis lice were found in his pubic and anal regions. In addition, we analyzed 27 lice from nine cases using a molecular method that targets the cytochrome c oxidase subunit I (COI) gene (423 bp). The sequencing results suggested a lack of diversity, and the sequences, when compared with references in the National Center for Biotechnology Information (NCBI) database, were identical to sequences found in the suburbs of Paris, France, and Florida, United States. Furthermore, PCR analysis was conducted to determine whether the pubic lice carried pathogenic Rickettsia or Acinetobacter spp., and negative results were found. In Taiwan, pthiriasis has been documented in sporadic reports. A total of 11 cases were reported in eight articles in Taipei, Taichung, and Chiayi, spanning from 1942 to 2012. Of these, one case involved infestation in the pubic region, three cases received a diagnosis of pthiriasis palpebrarum, one case received a diagnosis of pthiriasis capitis, one case received a diagnosis of both pthiriasis palpebrarum and pthiriasis capitis, and five cases involved infestation both on the eyelashes and in the pubic region. This study indicates that pthiriasis has not been eliminated in Taiwan but has rather been neglected. Future clinical studies in other regions of Taiwan are necessary for foundational medical entomological knowledge to be established and for effective public health education to be conducted. |
本系統中英文摘要資訊取自各篇刊載內容。