Melero M, Rigou R C, Lloveras J, Gennaro O
Departamento de Medicina, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Medicina (B Aires). 1991;51(3):244-8.
A 40 year old man was admitted with prolonged fever, hypereosinophilia, increased serum levels of cholestasis enzymes and low density masses in the hepatic computed tomography (CT). A liver needle biopsy was performed under CT control. Neoplastic, pyogenic or amoebic etiology were excluded. Stool parasitologic examination was also negative. A diagnosis of hepatic fasciolasis was based on the finding of operculate eggs in duodenal juice obtained by duodenal aspiration. The patient was successfully treated with triclabendazole (10/mg/kg/single dose). The purpose of this communication is to emphasize 1) that prolonged fever with hypereosinophilia and focal lesions in hepatic CT suggest the presence of fasciola hepatica which must be investigated particularly in duodenal juice; 2) the CT aspects of this disease; 3) that triclabendazole, a benzimidazolic compound, is a new therapeutic possibility acting on immature and adult forms of the parasite in the liver.
一名40岁男性因长期发热、嗜酸性粒细胞增多、血清胆汁淤积酶水平升高以及肝脏计算机断层扫描（CT）显示低密度肿块而入院。在CT引导下进行了肝脏穿刺活检。排除了肿瘤、化脓性或阿米巴病因。粪便寄生虫学检查也为阴性。肝片形吸虫病的诊断基于在十二指肠抽吸获得的十二指肠液中发现有盖虫卵。该患者用三氯苯达唑（10mg/kg/单剂量）成功治疗。本文的目的是强调：1）长期发热伴嗜酸性粒细胞增多以及肝脏CT中的局灶性病变提示存在肝片形吸虫，必须特别对十二指肠液进行检查；2）该疾病的CT表现；3）三氯苯达唑，一种苯并咪唑类化合物，是一种作用于肝脏中寄生虫未成熟和成虫形式的新的治疗选择。
