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弓形虫病作为新发肺部浸润的病因。

Toxocariasis as a cause of new pulmonary infiltrates.

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Int J Tuberc Lung Dis. 2013 Mar;17(3):412-7. doi: 10.5588/ijtld.12.0273.

Abstract

SETTING

Patients with new pulmonary infiltrates on chest computed tomography (CT) scans at a tertiary centre in South Korea.

OBJECTIVE

To demonstrate associations among radiological changes, blood eosinophilia (E) and Toxocara (T) seropositivity.

DESIGN

We retrospectively reviewed blood eosinophilia, Toxocara seropositivity, history of raw meat intake and radiological features, and divided study patients into four groups according to blood eosinophilia and Toxocara seropositivity.

RESULTS

Among 150 patients, 62 were E- and T-positive (E+T+), 45 were E-negative and T-positive (E-T+), 7 were E-positive and T-negative (E+T-), and 36 were E- and T-negative (E-T-). History of raw meat intake was found in 95 (63%) patients. The type and number of lesions on CT did not show any significant differences among the four groups. Among 119 patients who were not diagnosed with a specific disease, transient or migrating lesions were seen in 93% of E+T+, 93% of E-T+, 80% of E+T- and 52% of E-T- patients (P < 0.0001). Furthermore, the frequencies of migrating or new lesions and improvement were significantly higher in the Toxocara-positive group (88/95, 93%) than in the Toxocara-negative group (14/24, 58%; P = 0.002).

CONCLUSION

Transient and migratory pulmonary infiltrates on chest CT scans were associated with blood eosinophilia and Toxocara seropositivity. Clinicians should consider asymptomatic toxocariasis as a cause of unexplained new pulmonary infiltrates in countries with dietary habits of raw meat intake.

摘要

背景

在韩国的一家三级中心,对胸部计算机断层扫描 (CT) 上出现新肺部浸润的患者进行研究。

目的

展示放射学改变、血嗜酸性粒细胞 (E) 和旋毛虫 (T) 血清阳性之间的关联。

设计

我们回顾性地审查了血嗜酸性粒细胞、旋毛虫血清阳性、生食摄入史和放射学特征,并根据血嗜酸性粒细胞和旋毛虫血清阳性将研究患者分为四组。

结果

在 150 名患者中,62 名血嗜酸性粒细胞和 T 阳性 (E+T+),45 名血嗜酸性粒细胞阴性和 T 阳性 (E-T+),7 名血嗜酸性粒细胞阳性和 T 阴性 (E+T-),36 名血嗜酸性粒细胞阴性和 T 阴性 (E-T-)。95 名(63%)患者有生食摄入史。CT 上的病变类型和数量在四组之间没有明显差异。在未明确诊断为特定疾病的 119 名患者中,E+T+患者中有 93%、E-T+患者中有 93%、E+T-患者中有 80%和 E-T-患者中有 52%出现一过性或游走性病变(P<0.0001)。此外,旋毛虫阳性组(88/95,93%)中出现游走性或新病变和改善的频率明显高于旋毛虫阴性组(14/24,58%;P=0.002)。

结论

胸部 CT 扫描上的短暂性和游走性肺部浸润与血嗜酸性粒细胞和旋毛虫血清阳性有关。在有生食摄入饮食习惯的国家,临床医生应将无症状旋毛虫病视为不明原因新肺部浸润的原因。

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