de Vries P J, Kerst J M, Kortbeek L M
Afd. Inwendige Geneeskunde, onderafd. Infectieziekten, Tropische Geneeskunde & Aids, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam.
Ned Tijdschr Geneeskd. 2001 Feb 17;145(7):322-5.
Two patients suffered from intermittent subcutaneous swellings of the face. A 41-year-old man recalled a recent episode with severe thoracic pain and at that time pleurisy was documented. In this patient there was pronounced eosinophilia. The other was a 32-year-old woman. Both patients had traveled to southeast Asia. Antibodies against Gnathostoma spinigerum were detectable in both patients. The first patient was treated with albendazole 200 b.i.d. for three weeks, but because of recurrent facial swelling, he was treated again with albendazole at a higher dose: 400 b.i.d. for eight weeks, which the swellings did not recur. The second patient was not treated because the frequency of the swellings had already decreased spontaneously. Gnathostomiasis is an infection by the nematode G. spinigerum. The main route of human infection is by eating insufficiently not well-cooked fish or frog. The initial infection is often not recognised, but severe symptoms can occur. In humans, the larva of the nematode does not develop further but may wander through the subcutaneous tissues. Untreated, the infection usually runs a mild, self limiting course, but complications such as invasion of the central nervous system or of the eye have been described. Treatment with albendazole reduces recurrence of swellings.
两名患者面部出现间歇性皮下肿胀。一名41岁男性回忆近期有一次严重胸痛发作，当时记录有胸膜炎。该患者有明显嗜酸性粒细胞增多。另一名是32岁女性。两名患者均去过东南亚。两名患者均检测到抗棘颚口线虫抗体。第一名患者接受阿苯达唑200毫克每日两次治疗三周，但因面部肿胀复发，又接受更高剂量阿苯达唑治疗：400毫克每日两次，治疗八周，此后肿胀未再复发。第二名患者未接受治疗，因为肿胀频率已自行降低。颚口线虫病是由棘颚口线虫引起的感染。人类感染的主要途径是食用未充分煮熟的鱼或青蛙。初始感染往往未被识别，但可能出现严重症状。在人类中，线虫幼虫不会进一步发育，但可能在皮下组织游走。未经治疗，感染通常呈轻度、自限性病程，但也有中枢神经系统或眼部侵袭等并发症的报道。阿苯达唑治疗可减少肿胀复发。
