Takamatsu Kazufumi, Sumitani Mitsuhiro, Nanjyou Shigeki, Nishijima Masayoshi, Syoji Seiichi, Takifuji Nobuhide, Kiyota Hidemi, Daga Haruko, Takeda Koji
Department of Respiratory Medicine, Osaka City General Hospital.
Nihon Kokyuki Gakkai Zasshi. 2008 Oct;46(10):836-41.
A 42-year-old man presented at our emergency department with fever, sputum, and dyspnea. His chest X-ray films showed ground-glass opacities mainly in the upper and middle lung fields. We diagnosed pneumonia, gave antibiotic treatment, and his symptoms improved. However he later showed eosinophilia. We performed additional workup, and diagnosed Toxocara canis larva migrans. We treated him with albendazole for four weeks, but his eosinophil count rose again from the end of treatment one month later. Therefore we performed additional treatment with albendazole for 8 weeks, after which the clinical imaging findings and serum antibody titer improved. There are few reports about additional treatment for Toxocara canis larva migrans, and there is not yet a consensus. We think that we should consider additional treatment in cases that do not show improvement on initial treatment.
一名42岁男性因发热、咳痰和呼吸困难就诊于我院急诊科。他的胸部X光片显示主要在上肺野和中肺野出现磨玻璃样阴影。我们诊断为肺炎，给予抗生素治疗，其症状有所改善。然而，他后来出现嗜酸性粒细胞增多。我们进行了进一步检查，诊断为犬弓首线虫幼虫移行症。我们用阿苯达唑治疗他四周，但一个月后治疗结束时他的嗜酸性粒细胞计数再次升高。因此，我们用阿苯达唑进行了为期8周的额外治疗，之后临床影像学表现和血清抗体滴度均有所改善。关于犬弓首线虫幼虫移行症额外治疗的报道很少，目前尚未达成共识。我们认为，对于初始治疗无改善的病例应考虑额外治疗。
