Abounadi R, El Meziane A, El Biaze M, Bakhatar A, Yassine N, Alaoui-Yazidi A, Bahlaoui A
Service des Maladies Respiratoires, CHU Ibn Rochd, Casablanca, 20000 Morocco.
Rev Pneumol Clin. 2006 Sep;62(4):247-51. doi: 10.1016/s0761-8417(06)75449-9.
Multiple thoracic hydatic disease involving a cardiac and pulmonary localization is exceptional and prognosis is poor. We report a case in a 21-year-old male who presented repeated episodes of hemoptysis. The chest x-ray showed multiple opacities. The thoracic computed tomography and echocardiography visualized cystic formations in the heart and the pulmonary arteries. Hydatic serology was strongly positive. Medical treatment with albendazole was given but the patient died from massive hemoptysis before the cardiac and pulmonary artery cysts could be removed surgically (a procedure which requires extracorporeal circulation). A hydatic cyst of the pulmonary artery is usually secondary to a cardiac localization. The risk is dissemination into the pulmonary and eventually systemic circulation. An arterial localization must be carefully ruled out in all patients with multiple or cardiac hydatidosis. Treatment is surgical to avoid dissemination.
多发性胸内包虫病累及心脏和肺部较为罕见,预后较差。我们报告一例21岁男性病例,该患者反复出现咯血。胸部X线显示多个不透明影。胸部计算机断层扫描和超声心动图显示心脏和肺动脉有囊性结构。包虫血清学检查呈强阳性。给予阿苯达唑药物治疗,但患者在心脏和肺动脉囊肿能够通过手术切除(该手术需要体外循环)之前死于大量咯血。肺动脉包虫囊肿通常继发于心脏部位。风险是扩散到肺部并最终进入体循环。对于所有患有多发性或心脏包虫病的患者,必须仔细排除动脉部位的病变。治疗应采取手术方式以避免扩散。