Scott J A, Davidson R N, Moody A H, Bryceson A D
Department of Clinical Tropical Medicine, Hospital for Tropical Diseases, London, United Kingdom.
Scand J Infect Dis. 1991;23(6):777-80. doi: 10.3109/00365549109024307.
A case is reported of a 32-year-old traveller with loiasis, schistosomiasis and African trypanosomiasis. The patient had been working in oil exploration in Nigeria and Gabon and presented with Calabar swellings and carpal tunnel syndrome. Serology for all 3 diseases was positive but microfilariae of Loa loa and ova of schistosomiasis were not found. Treatment with diethylcarbamazine and praziquantel was given for loiasis and schistosomiasis respectively. Trypanosomes were isolated from a lymph node aspirate only after repetition of the procedure 2 months later and the patient was treated with suramin. He developed a drug induced nephritis and was then treated successfully with alpha-difluoromethylornithine. There is a discussion of the difficulties encountered making these diagnoses in Europeans particularly where there are atypical clinical features. The risks of rural work in West Africa are noted and the importance of considering all parasitic diseases relevant to the travel/occupational history is emphasised.
报告了一例32岁旅行者同时感染罗阿丝虫病、血吸虫病和非洲锥虫病的病例。该患者曾在尼日利亚和加蓬从事石油勘探工作，出现了卡拉巴肿和腕管综合征。所有这三种疾病的血清学检查均呈阳性，但未发现罗阿丝虫微丝蚴和血吸虫卵。分别用乙胺嗪和吡喹酮治疗罗阿丝虫病和血吸虫病。仅在2个月后重复该操作后才从淋巴结穿刺物中分离出锥虫，患者接受了苏拉明治疗。他出现了药物性肾炎，随后用α-二氟甲基鸟氨酸成功治疗。文中讨论了在欧洲人身上做出这些诊断时遇到的困难，特别是在存在非典型临床特征的情况下。指出了西非农村工作的风险，并强调了考虑与旅行/职业史相关的所有寄生虫病的重要性。
