Sharma Chollasap, Piyaphanee Watcharapong, Watthanakulpanich Dorn
Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Am J Trop Med Hyg. 2017 Nov;97(5):1611-1615. doi: 10.4269/ajtmh.17-0239. Epub 2017 Aug 18.
A 15-year-old Thai girl was referred to the Hospital for Tropical Diseases of Mahidol University with a 3-week history of an intermittent migratory mass on the forehead. She was diagnosed with cutaneous gnathostomiasis. The patient was treated with albendazoleat 400 mg orally twice a day for 3 weeks, with good compliance. She revisited the hospital after 3 months and was seen to have been unresponsive to the initial treatment. There was intermittent swelling in her right upper eyelid along with mild redness around her right upper and lower eyelids. Another attempt of treatment was made with ivermectin 0.2 mg/kg/day for two consecutive days. This is a case of gnathostomiasis in full sequence, with complete follow-up. The case report starts from the beginning of the symptoms until the antibodies against decline to negative, confirmed by the western blot test. It took around 18 months to see the western blot test change to a negative result. The resolved clinical symptoms were possibly due to the responsiveness of the patient to ivermectin or the albendazole and ivermectin combination or even the coadministration of antibiotics afterward.
一名15岁的泰国女孩因前额出现间歇性游走性肿块3周,被转诊至玛希隆大学热带病医院。她被诊断为皮肤颚口线虫病。患者接受阿苯达唑治疗,每天口服400毫克,分两次服用,持续3周,依从性良好。3个月后她再次到医院就诊,发现对初始治疗无反应。她的右上眼睑间歇性肿胀,右上眼睑和下眼睑周围有轻度发红。又尝试连续两天使用伊维菌素,剂量为0.2毫克/千克/天进行治疗。这是一例完整病程并进行了全面随访的颚口线虫病病例报告。病例报告从症状出现开始,直至通过蛋白质印迹试验确认抗颚口线虫抗体降至阴性。大约花了18个月蛋白质印迹试验结果才变为阴性。临床症状的缓解可能是由于患者对伊维菌素、阿苯达唑与伊维菌素联合用药,甚至之后联合使用抗生素有反应。