Department of Internal Medicine, University of Tennessee College of Medicine at Chattanooga, 1310 Reserve Way #104, Chattanooga, TN 37421, USA.
J Gen Intern Med. 2009 Oct;24(10):1161-5. doi: 10.1007/s11606-009-1062-1. Epub 2009 Jul 25.
Echinococcus granulosus, which causes cystic echinococcosis, is an uncommon condition in the United States. We report a case of a 78-year-old Caucasian female who presented to her primary care physician in 1999 with right upper quadrant pain. She had a history of frequent foreign travel. Abdominal imaging demonstrated a 12.5-cm hepatic cyst. The cyst was drained and the pathology report on the fluid indicated no bacterial, parasitic, or malignant etiology. Serology tests for Entamoeba and Echinococcus antibodies were negative. The patient underwent multiple hepatic cyst aspirations until 2008 for recurring symptoms. In 2008, abdominal imaging demonstrated solid internal components within the cyst. Repeat Echinococcus antibodies ordered were abnormally elevated. Cyst aspiration demonstrated Echinococcus protoscolex. We report this case to discuss the diagnosis and management of hydatid cyst and to emphasize that with increasing globalization, physicians must maintain a high index of clinical suspicion for parasitic etiologies in patients with hepatic cysts.
棘球蚴，可引起包虫病，在美国并不常见。我们报告了一例 78 岁白人女性的病例，她于 1999 年因右上腹疼痛就诊于初级保健医生。她有频繁的出国旅行史。腹部影像学检查显示肝脏有一个 12.5 厘米的囊肿。对囊肿进行了引流，液体的病理学报告表明没有细菌、寄生虫或恶性病因。对 Entamoeba 和 Echinococcus 抗体的血清学检测均为阴性。该患者因反复发作的症状，于 2008 年之前多次进行肝囊肿抽吸。2008 年，腹部影像学显示囊肿内有实性内部成分。重复检测的棘球蚴抗体异常升高。囊肿抽吸显示有棘球蚴原头节。我们报告这个病例，以讨论包虫囊肿的诊断和管理，并强调随着全球化的增加，医生必须对有肝囊肿的患者保持高度的寄生虫病因临床怀疑。
