Department of Respiratory Medicine, Yokohama-City Seibu Hospital, St. Marianna University School of Medicine, Asahi-ku, Yokohama, Japan.
J Infect Chemother. 2010 Feb;16(1):49-52. doi: 10.1007/s10156-009-0005-4.
We report a patient, a 52-year-old man from Laos, who had come to Japan at 30 years of age, but had maintained a habit of eating raw freshwater crabs. The patient visited a physician for left chest pain in January 2007. Infiltration and mass-like shadows were noted in the left superior and inferior lobes on chest X-ray. Diagnosis could not be made by bronchial brushing, but eggs were present in sputum cytology 3 days after bronchoscopy. Therefore, paragonimiasis was diagnosed. The peripheral eosinophil count had increased to 2550/μl and the serum IgE level was elevated, at 71000 IU/ml. Multiple-dot enzyme-linked immunosorbent assay (ELISA) for specific IgG antibodies in serum was positive for Paragonimus westermani and P. miyazakii. Paragonimiasis may have been caused by the style of Laotian cooking without heating. Because the habit of eating raw freshwater crabs is common in Laos, Laos is one of the countries where paragonimiasis is prevalent. For patients from Laos with lung diseases, differentiation including paragonimiasis is required.
我们报告了一例患者，他是一名来自老挝的 52 岁男性，30 岁时来到日本，但一直保持吃生淡水蟹的习惯。该患者于 2007 年 1 月因左侧胸痛就诊。胸部 X 线显示左肺上、下叶浸润和块状阴影。支气管刷检未能明确诊断，但支气管镜检查 3 天后痰细胞学检查发现虫卵。因此，诊断为并殖吸虫病。外周血嗜酸性粒细胞计数增至 2550/μl，血清 IgE 水平升高，达 71000 IU/ml。血清特异性 IgG 抗体的酶联免疫吸附试验（ELISA）对卫氏并殖吸虫和宫崎并殖吸虫均为阳性。该患者可能因老挝的烹饪方式未加热而感染并殖吸虫病。由于老挝人有吃生淡水蟹的习惯，老挝是并殖吸虫病流行的国家之一。对于来自老挝的肺部疾病患者，需要进行包括并殖吸虫病在内的鉴别诊断。
