Ramachandran Jeyamani, Chandramohan Anuradha, Gangadharan Sajith Kattiparambil, Unnikrishnan L S, Priyambada Leena, Simon Anna
Professor and Head, Department of Hepatology, Christian Medical College Hospital, Vellore, Tamilnadu 632004, India.
Trop Doct. 2013 Oct;43(4):154-7. doi: 10.1177/0049475513507254. Epub 2013 Oct 7.
Eosinophilic necrotizing granulomas in the liver, known as visceral larva migrans (VLM), are a rare cause of liver abscesses. The term VLM refers to infections in human tissues caused by the larval stages of ascarid worms of dogs and cats. We report two cases of VLM which presented with high grade fever and abdominal pain for 3-4 months. Marked peripheral eosinophilia, multiple confluent perivenous lesions in the right lobe of liver with characteristic migratory tracts on imaging and biopsy evidence of necrotizing eosinophilic granulomas led to the diagnosis. Complete recovery was achieved with repeated courses of a combination of anthelmintics.
肝脏中的嗜酸性坏死性肉芽肿，即内脏幼虫移行症（VLM），是肝脓肿的一种罕见病因。VLM这一术语指的是由犬猫蛔虫幼虫阶段引起的人体组织感染。我们报告两例VLM病例，患者出现高热和腹痛3 - 4个月。显著的外周嗜酸性粒细胞增多、肝脏右叶多个融合的静脉周围病变，影像学上有特征性的移行轨迹，以及坏死性嗜酸性肉芽肿的活检证据，从而得出诊断。通过反复使用驱虫药联合治疗实现了完全康复。
