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胆道华支睾吸虫病合并胆囊炎:一种罕见的感染病例并文献复习。

Biliary Taeniasis with Cholecystitis: An Unusual Case of Infection with a Literature Review.

机构信息

Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Molecular Parasitology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, Korea.

出版信息

Am J Trop Med Hyg. 2019 Jan;100(1):135-139. doi: 10.4269/ajtmh.18-0633.

Abstract

Taeniasis is a cosmopolitan helminthic disease caused by species, which included , , and . These parasites typically infect the small intestine, but cases of aberrant migration have been reported. We treated a 70-year-old man who presented with vomiting and colicky abdominal pain. On physical examination, Murphy's sign was positive, and laboratory findings indicated severe inflammation. Computed tomography and magnetic resonance cholangiopancreatography revealed typical features of cholecystitis. An 82-cm-long, slender and degenerated, parasite-like organism was aspirated through a percutaneous transhepatic gallbladder drainage tube. After extensive washing of the organism, we detected yellowish-brown colored, spherical 37.9 × 33.8-µm-sized taenid eggs with thick transverse striations. Hematoxylin-eosin-stained worm sections also contained Taeniidae eggs. Polymerase chain reaction amplification of DNA extracted from the worm with species-specific cytochrome c1 () primer sets detected a specific fragment. Because of sustained high fever combined with inflammatory signs, the patient underwent laparoscopic cholecystectomy and inflamed gallbladder removal. A histopathologic specimen demonstrated chronic reactive cholecystitis. The patient's fever and leukocytosis rapidly resolved after surgery. We experienced an uncommon case of biliary taeniasis representing cholecystitis caused by adult worm of .

摘要

带绦虫病是一种世界性的寄生虫病,由 、 、 等物种引起。这些寄生虫通常感染小肠,但也有报道称它们会发生异常迁移。我们治疗了一位 70 岁的男性患者,他出现呕吐和绞痛性腹痛。体格检查时,墨菲征阳性,实验室检查提示严重炎症。计算机断层扫描和磁共振胰胆管成像显示出典型的胆囊炎特征。通过经皮经肝胆囊引流管抽吸取出一条 82 厘米长、细长且退化的、类似寄生虫的生物体。对该生物体进行广泛冲洗后,我们检测到了黄褐色、球形、大小为 37.9×33.8-µm 的带绦虫卵,其上有厚的横向条纹。用苏木精-伊红染色的虫体切片也含有带科虫卵。用种特异性细胞色素 c1()引物从虫体中提取的 DNA 的聚合酶链反应扩增检测到了一个特定片段。由于持续高热合并炎症迹象,患者接受了腹腔镜胆囊切除术和发炎的胆囊切除术。组织病理学标本显示慢性反应性胆囊炎。手术后,患者的发热和白细胞增多迅速得到缓解。我们遇到了一例不常见的胆道带绦虫病,由 的成虫引起胆囊炎。

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本文引用的文献

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