Becker Sören L, Fähndrich Sebastian, Trudzinski Franziska C, Gärtner Barbara, Langer Frank, Becker Torben K, Bals Robert, Lepper Philipp M, Lensch Christian
Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Department of Medicine V - Pneumology, Allergology and Critical Care Medicine, ECLS Centre Saar, Saarland University, Homburg/Saar, Germany.
Int J Infect Dis. 2017 Nov;64:47-49. doi: 10.1016/j.ijid.2017.09.001. Epub 2017 Sep 8.
Extracorporeal membrane oxygenation (ECMO) has been used successfully for the treatment of patients with respiratory failure due to severe infections. Although rare, parasites can also cause severe pulmonary disease. Tapeworms of the genus Echinococcus give rise to the development of cystic structures in the liver, lungs, and other organs. Acute cyst rupture leads to potentially life-threatening infection, and affected patients may deteriorate rapidly. The case of a young woman from Bulgaria who was admitted to hospital with severe dyspnoea, progressive chest pain, and haemoptysis is described. Computed tomography of the chest was pathognomonic for cystic echinococcosis with acute cyst rupture. Following deterioration on mechanical ventilation, she was cannulated for veno-venous ECMO. The patient's condition improved considerably, and she was weaned successfully from ECMO and mechanical ventilation. Following lobectomy of the affected left lower lobe, the patient was discharged home in good condition. This appears to be the first report of the successful use of ECMO as salvage treatment for a severe manifestation of a helminthic disease. Due to recent migration to Western Europe, the number of patients presenting with respiratory failure due to pulmonary echinococcosis with cyst rupture is likely to increase.
体外膜肺氧合（ECMO）已成功用于治疗因严重感染导致呼吸衰竭的患者。虽然寄生虫引起严重肺部疾病的情况罕见，但也确实存在。棘球绦虫属的绦虫可在肝脏、肺和其他器官中形成囊性结构。急性囊肿破裂会导致可能危及生命的感染，受影响的患者病情可能迅速恶化。本文描述了一名来自保加利亚的年轻女性，她因严重呼吸困难、进行性胸痛和咯血入院。胸部计算机断层扫描显示为囊性棘球蚴病伴急性囊肿破裂。在机械通气下病情恶化后，她接受了静脉 - 静脉ECMO插管治疗。患者病情显著改善，并成功撤机，脱离ECMO和机械通气。在切除受影响的左下叶后，患者康复出院。这似乎是关于成功使用ECMO作为蠕虫病严重表现的挽救治疗的首例报告。由于近期向西欧的移民，因肺棘球蚴病囊肿破裂导致呼吸衰竭的患者数量可能会增加。
