Dezsényi Balázs, Szabó Bálint Gergely, Danka József, Ocskay László, Bor László, Csepregi András, Babarczi Edit, Petrovicz Edina, Budai József
Infektológiai Osztály, Dél-pesti Centrumkórház, Országos Hematológiai és Infektológiai Intézet Budapest, Albert Flórián út 5-7., 1097.
Parazitológiai Osztály, Országos Közegészségügyi Intézet Budapest.
Orv Hetil. 2019 Jun;160(24):952-957. doi: 10.1556/650.2019.31405.
We report a case of a 41-year-old female patient presenting with watery diarrhoea and myalgia in the winter-season. Before her symptoms started she had participated in a pig slaughtering with her family. Some of the family members also became ill. On her physical examination periorbital odema and myalgia were found. Eosinophilia, hypalbuminaemia, elevated lactate dehydrogenase and creatin kinase levels were detected on laboratory investigations. The clinical picture, the laboratory findings and background epidemiological data implied the diagnosis of trichinellosis and albendazol was started. Serum gained on the 22nd post-infectious day turned out to be equivocal for trichinellosis. For this reason and because of the refractory fever a muscle-biopsy was done. Granulomatous myositis described by histology and seropositivity from the repeated serum sample on the 62nd post-infectious day finally confirmed the diagnosis. During the course of the disease, we experienced elevation of troponin I suggesting myocarditis, but it was accompanied neither with abnormal ECG signs nor characteristic symptoms. Almost a century ago, a case report was published in Hungarian with a similar introduction. Trichinellosis in that epidemic setting led to the death of five people. Orv Hetil. 2019; 160(24): 952-957.
我们报告一例41岁女性患者,在冬季出现水样腹泻和肌痛。在其症状出现之前,她与家人一起参与了一次杀猪活动。一些家庭成员也生病了。体格检查发现其有眶周水肿和肌痛。实验室检查检测到嗜酸性粒细胞增多、低白蛋白血症、乳酸脱氢酶和肌酸激酶水平升高。临床症状、实验室检查结果及背景流行病学数据提示旋毛虫病诊断成立,遂开始使用阿苯达唑治疗。感染后第22天采集的血清对旋毛虫病检测结果不明确。因此,由于发热难治,进行了肌肉活检。组织学描述的肉芽肿性肌炎以及感染后第62天重复血清样本的血清学阳性最终确诊了该病。在疾病过程中,我们发现肌钙蛋白I升高,提示心肌炎,但未伴有异常心电图表现或特征性症状。近一个世纪前,匈牙利发表了一篇病例报告,引言与此类似。在那次流行中,旋毛虫病导致5人死亡。《匈牙利医学周报》。2019年;160(24):952 - 957。