Yoshikawa Masahide, Koyama Noriko, Hontsu Shigeto, Yamamoto Yoshifumi, Ogawa Shuhei, Nakamura Takahito, Mizuno Youka, Miura Sachiko, Mikasa Kei-ichi, Kimura Hiroshi
Department of Parasitology, Nara Medical University.
Nihon Kokyuki Gakkai Zasshi. 2010 May;48(5):351-6.
We encountered 8 adult cases of pulmonary toxocariasis. Five were asymptomatic, 1 had transient chest pain, 1 suffered from arthralgia and migrating skin pain, and 1 had chest discomfort due to pneumothorax. Infection was associated with the consumption of raw liver with paratenic hosts in 5 patients. The cause was suspected to be contact with infected young dogs in 1 case and was undetermined in 2 cases. All 8 cases showed some abnormalities in their laboratory examination results including eosinophilia (>500/microl) and elevated IgE (>100 IU), and all had positive results in serological examinations for the larval excretory-secretory product of Toxocara canis. In 7 patients, excluding the patient with pneumothorax, chest computed tomography demonstrated multiple small pulmonary lesions, most of which were either nodules with halos, or ground-glass opacities. One patient recovered without medication, while the other 7 were treated with albendazole (ABZ) with good responses. Although the optimal duration of ABZ therapy has not been established, 4 weeks or longer seemed necessary to obtain a complete cure in pulmonary toxocariasis.
我们遇到了8例成人肺弓蛔虫病病例。5例无症状,1例有短暂胸痛,1例有关节痛和游走性皮肤疼痛,1例因气胸出现胸部不适。5例患者的感染与食用含有转续宿主的生肝有关。1例疑似病因是接触感染的幼犬,2例病因不明。所有8例患者的实验室检查结果均有一些异常,包括嗜酸性粒细胞增多(>500/微升)和IgE升高(>100 IU),并且所有患者犬弓首线虫幼虫排泄-分泌产物的血清学检查结果均为阳性。7例患者(不包括气胸患者)的胸部计算机断层扫描显示肺部有多个小病灶,其中大多数为有晕圈的结节或磨玻璃样混浊。1例患者未经药物治疗即康复,其他7例接受了阿苯达唑(ABZ)治疗,反应良好。虽然尚未确定ABZ治疗的最佳疗程,但在肺弓蛔虫病中似乎需要4周或更长时间才能完全治愈。