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胆道蛔虫病与严重细菌感染结局:巴西一家儿科医院的三例报告。

Biliary ascariasis and severe bacterial outcomes: Report of three cases from a paediatric hospital in Brazil.

机构信息

Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador-BA, Brazil.

Hospital da Criança das Obras Sociais de Irmã Dulce, Salvador-BA, Brazil.

出版信息

Int J Infect Dis. 2020 Jun;95:115-117. doi: 10.1016/j.ijid.2020.03.045. Epub 2020 Mar 30.

Abstract

INTRODUCTION

Biliary ascariasis, although uncommon, can lead to infectious complications and severe outcomes. This study reported three patients with biliary ascariasis and who were admitted to a paediatric hospital in Salvador, Brazil.

CASE REPORTS

Case 1: A 1-year-old boy, with HIV, hospitalised with diarrhoea, fever, pain, and abdominal distension. He underwent an exploratory laparotomy, which showed peritonitis secondary to a perforation of the hepatic duct by ascaris. Case 2: A 3-year-old boy admitted with fever, abdominal pain and jaundice. Imaging examination was suggestive of ascaris in the intrahepatic biliary tract and a hepatic abscess. Case 3: A 7-year-old boy who was hospitalised with a history of abdominal colic, jaundice and fever, with a suggestive image of ascaris in the biliary tract and evolution to sepsis.

DISCUSSION

Three cases of biliary ascariasis were reported with severe infectious complications involving peritonitis, hepatic abscess and sepsis.

CONCLUSION

In endemic regions, biliary ascariasis should be considered in cases with jaundice, abdominal pain and fever, due to its morbidity and risk of complications.

摘要

介绍

胆道蛔虫病虽然不常见,但可导致感染性并发症和严重后果。本研究报告了巴西萨尔瓦多一家儿科医院收治的 3 例胆道蛔虫病患者。

病例报告

病例 1:1 岁男孩,HIV 阳性,因腹泻、发热、腹痛和腹胀住院。他接受了剖腹探查术,结果显示肝管穿孔继发的腹膜炎,穿孔是由蛔虫引起的。病例 2:3 岁男孩因发热、腹痛和黄疸住院。影像学检查提示肝内胆管内有蛔虫,并有肝脓肿。病例 3:7 岁男孩因腹痛、黄疸和发热住院,胆道内有蛔虫的提示性图像,病情进展为败血症。

讨论

报告了 3 例胆道蛔虫病,均伴有严重的感染性并发症,包括腹膜炎、肝脓肿和败血症。

结论

在流行地区,对于出现黄疸、腹痛和发热的患者,应考虑胆道蛔虫病,因其具有发病和并发症的风险。

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