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溃疡性结肠炎患者中表现为侵袭性曲霉病的肺弓蛔虫病

Pulmonary toxocariasis mimicking invasive aspergillosis in a patient with ulcerative colitis.

作者信息

Park Eun Jin, Song Joon Young, Choi Min Ju, Jeon Ji Ho, Choi Jah-Yeon, Yang Tae Un, Hong Kyung Wook, Noh Ji Yun, Cheong Hee Jin, Kim Woo Joo

机构信息

Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea.

Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea. ; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul 136-705, Korea.

出版信息

Korean J Parasitol. 2014 Aug;52(4):425-8. doi: 10.3347/kjp.2014.52.4.425. Epub 2014 Aug 29.

Abstract

A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.

摘要

一名45岁男性,患有溃疡性结肠炎,出现发热和干咳症状。最初,由于半乳甘露聚糖检测呈阳性,该患者被认为患有侵袭性曲霉病。他先接受了两性霉素B治疗,随后使用伏立康唑。然而,患者的临床症状和影像学表现均恶化。肺活检显示为嗜酸性粒细胞性肺炎,弓形虫抗原酶联免疫吸附测定(ELISA)呈阳性,最终诊断为肺弓蛔虫病。在接受阿苯达唑和辅助性类固醇治疗10天后,患者完全康复,未留下任何后遗症。对于对抗生素治疗无反应的亚急性或慢性肺炎患者,尤其是伴有嗜酸性粒细胞增多的病例,应考虑肺弓蛔虫病的可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c2d/4170039/8e219e386200/kjp-52-425-g001.jpg

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