Treska V, Sutnar A, Mukensnabl P, Manakova T, Sedlacek D, Mirka H, Ferda J
Department of Surgery, School of Medicine, University Hospital, Pilsen, Czech Republic.
Bratisl Lek Listy. 2011;112(11):644-7.
Toxocariasis is a parasitic infection caused by Toxocara canis or Toxocara cati. It is distributed worldwide. Liver is the main organ affected by Toxocara infection, typically with multiple eosinophilic infiltrates. Liver abscess formation is a very rare condition.
The authors report on a case of Toxocariasis infection with abscess formation in the right liver lobe. The diagnosis was made upon patient's history, clinical examination, use of ultrasonography, computed tomography and especially upon positive serologic test and hypereosinophilia. After unsuccessful conservative treatment (Mebendazole, antibiotics and corticoids), right hepatectomy was performed.
The postoperative course was complicated by biliary fistula in the resection area. The complication was successfully managed by temporary stent implantation to the left hepatic duct. Six months after the operation, the patient is with no complications.
Liver abscess formation is a rare condition associated with Toxocara infection. It is still a matter of debate whether liver abscess results from severe parasitic infection or whether human toxocariasis is a predisposing cause of pyogenic liver abscess formation. Liver resection is the only treatment option when sepsis fails to respond to conservative treatment (Fig. 5, Ref. 22).
弓蛔虫病是由犬弓蛔虫或猫弓蛔虫引起的寄生虫感染。该病在全球范围内均有分布。肝脏是受弓蛔虫感染影响的主要器官，通常会出现多处嗜酸性粒细胞浸润。肝脓肿形成是一种非常罕见的情况。
作者报告了一例右肝叶出现脓肿形成的弓蛔虫病感染病例。根据患者病史、临床检查、超声检查、计算机断层扫描结果，特别是血清学检测呈阳性和嗜酸性粒细胞增多症做出诊断。在保守治疗（甲苯达唑、抗生素和皮质类固醇）失败后，进行了右肝切除术。
术后病程因切除部位出现胆瘘而复杂化。通过向左肝管临时植入支架成功处理了该并发症。术后六个月，患者无并发症。
肝脓肿形成是与弓蛔虫感染相关的罕见情况。肝脓肿是由严重寄生虫感染引起，还是人类弓蛔虫病是化脓性肝脓肿形成的易感因素，目前仍存在争议。当败血症对保守治疗无反应时，肝切除术是唯一的治疗选择（图5，参考文献22）。
