Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
BMC Infect Dis. 2011 Jan 29;11:33. doi: 10.1186/1471-2334-11-33.
Human pythiosis is an emerging and life-threatening infectious disease caused by Pythium insidiosum. It occurs primarily in tropical, subtropical and temperate areas of the world, including Thailand. The aim of this report is to present the first pediatric case of typical vascular pythiosis.
A 10-year-old boy with underlying β-thalassemia presented with gangrenous ulcers and claudication of the right leg which were unresponsive to antibiotic therapy for 6 weeks. Computerized tomography angiography indicated chronic arterial occlusion involving the right distal external iliac artery and its branches. High-above-knee amputation was urgently done to remove infected arteries and tissues, and to stop disease progression. Antibody to P. insidiosum was detected in a serum sample by the immunoblot and the immunochromatography tests. Fungal culture followed by nucleic sequence analysis was positive for P. insidiosum in the resected iliac arterial tissue. Immunotherapeutic vaccine and antifungal agents were administered. The patient remained well and was discharged after 2 months hospitalization without recurrence of the disease. At the time of this communication he has been symptom-free for 2 years.
The child presented with the classical manifestations of vascular pythiosis as seen in adult cases. However, because pediatricians were unfamiliar with the disease, diagnosis and surgical treatment were delayed. Both early diagnosis and appropriate surgical and medical treatments are crucial for good prognosis.
人体棘球蚴病是一种由棘球蚴引起的新兴且危及生命的传染病。它主要发生在世界上的热带、亚热带和温带地区，包括泰国。本报告的目的是介绍首例典型血管性棘球蚴病的儿科病例。
一名 10 岁男孩患有β-地中海贫血症，出现坏疽性溃疡和右腿跛行，抗生素治疗 6 周后仍无反应。计算机断层血管造影显示右髂外动脉远端及其分支的慢性动脉闭塞。为了切除感染的动脉和组织，阻止疾病进展，紧急进行了高过膝截肢术。通过免疫印迹和免疫层析试验在血清样本中检测到棘球蚴抗体。切除的髂动脉组织的真菌培养和核酸序列分析均为棘球蚴阳性。给予免疫治疗疫苗和抗真菌药物。患者在住院 2 个月后情况良好出院，无疾病复发。在本次沟通时，他已经无症状 2 年。
患儿表现出与成人病例相似的典型血管性棘球蚴病表现。然而，由于儿科医生对该病不熟悉，导致诊断和手术治疗延误。早期诊断以及适当的手术和药物治疗对预后至关重要。
