Shrestha Merica, Shah Anita, Lettieri Christopher
Departments of Internal Medicine, Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC, USA.
South Med J. 2010 Feb;103(2):165-8. doi: 10.1097/smj.0b013e3181c0afc1.
Pleuropulmonary amebiasis is an uncommon complication of Entamoeba histolytica infection. It typically occurs in endemic regions including Central and South America, Africa and the Indian subcontinent. The case of a previously healthy US Army male stationed in Liberia with an acute onset of fevers, abdominal pain and bloody diarrhea is presented. He developed a productive cough with pleuritic chest pain and imaging revealed multiple liver abscesses, with rupture through the diaphragm causing a large right pleural empyema. A positive Entamoeba histolytica serum antibody and pleural fluid antigen confirmed the diagnosis. Surgical drainage of the pleural empyema and medical treatment with antiparasitics were necessary for symptom and disease resolution.
胸膜肺阿米巴病是溶组织内阿米巴感染的一种罕见并发症。它通常发生在包括中美洲、南美洲、非洲和印度次大陆在内的流行地区。本文介绍了一名曾驻利比里亚的健康美国陆军男性病例,该患者急性起病,出现发热、腹痛和血性腹泻。他出现了伴有胸膜炎性胸痛的咳痰,影像学检查显示多个肝脓肿,脓肿穿破膈肌导致右侧大量胸腔积脓。溶组织内阿米巴血清抗体和胸腔积液抗原阳性确诊了该病例。胸腔积脓的外科引流和抗寄生虫药物治疗对于缓解症状和治愈疾病是必要的。