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神经囊虫病:一位蒙古旅行者的病例研究,他曾前往中国和印度旅游,并对亚洲地区进行了最新的综述。

Neurocysticercosis: A case study of a Mongolian traveler who visited China and India with an updated review in Asia.

机构信息

Laboratory of Parasitology, National Center for Communicable Diseases, Ulaanbaatar, Mongolia.

Department of Radiology, Luxmed Hospital, Ulaanbaatar, Mongolia.

出版信息

Travel Med Infect Dis. 2017 Nov-Dec;20:31-36. doi: 10.1016/j.tmaid.2017.04.007. Epub 2017 May 3.

Abstract

BACKGROUND

Neurocysticercosis (NCC) of Taenia solium has never been reported in Mongolia. A Mongolian traveler who visited China and India presented with epileptic seizures after his return to Mongolia. Magnetic resonance imaging showed multiple ring enhancing lesions with edema surrounding several lesions in his brain that were initially diagnosed to be viral encephalitis or NCC.

METHODS

Serology for cysticercosis using diagnostic antigens partially purified by cation-exchange chromatography and chimeric recombinant antigens and DNA analysis of a proglottid found in the patient's stool were applied for differential diagnosis.

RESULTS

Serology showed strong positivity for NCC, and mitochondrial cox1 gene analysis revealed Indian but not Chinese haplotype of T. solium.

CONCLUSION

This NCC case was considered to be caused by eggs released from adult tapeworm(s) established after eating uncooked or undercooked pork contaminated with cysticerci during his stay in India. This is a case report of taeniasis and secondary NCC associated with travel to India with an updated review of NCC in Asia. Molecular tracking of the specimen is highly informative as a way to identify where the infection was acquired.

摘要

背景

蒙古未曾报告过猪带绦虫引起的神经囊尾蚴病(NCC)。一位蒙古旅行者在访问中国和印度后返回蒙古时出现癫痫发作。磁共振成像显示大脑中有多个环状增强病变,伴有水肿,几个病变周围也有水肿,最初被诊断为病毒性脑炎或 NCC。

方法

使用阳离子交换层析和嵌合重组抗原部分纯化的诊断抗原进行囊尾蚴病血清学检测,并对患者粪便中发现的一片绦虫节片进行 DNA 分析,以进行鉴别诊断。

结果

血清学检查显示 NCC 呈强阳性,线粒体 cox1 基因分析显示印度而非中国的猪带绦虫的单倍型。

结论

该例 NCC 被认为是由于旅行者在印度期间食用了含有囊尾蚴的未煮熟或未煮熟的猪肉,导致成虫释放虫卵而引起的。本文报告了一例前往印度旅行导致的带绦虫病和继发性 NCC,并对亚洲的 NCC 进行了更新的综述。对标本进行分子追踪是一种非常有用的方法,可以确定感染源在哪里。

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