Khamsai Sittichai, Howe Kathleen, Intapan Pewpan M, Maleewong Wanchai, Chotmongkol Verajit, Sawanyawisuth Kittisak
Drs. Khamsai, Chotmongkol, and Sawanyawisuth are with the Department of Medicine at Khon Kaen University in Khon Kaen, Thailand.
Drs. Intapan and Maleewong are with the Department of Parasitology at Khon Kaen University in Khon Kaen, Thailand.
Innov Clin Neurosci. 2021 Apr-Jun;18(4-6):40-43.
Severe rat lung worm disease (RLWD) is an uncommon condition, but it can result in severe complications and can be difficult to diagnose, necessitating awareness on the part of physicians everywhere. We review the clinical manifestations and diagnostic dilemmas of severe RLWD based on a case in Hawaii. A 50-year-old man developed mild headache, a burning sensation in the limbs, fever, and strained urination nine days after consuming lettuce contaminated with parasitic nematodes ( []). In time, his headache became more severe, and he developed purple semi-circular stripes at the base of nail beds. He sought medical attention, but the diagnosis was delayed, likely due to unfamiliarity with the condition by the initial treating clinician. The diagnosis was eventually based on evidence of cerebrospinal fluid (CSF), eosinophils, and positive polymerase chain reaction (PCR) of CSF for . Corticosteroid treatment was delayed, and albendazole was not administered due to a lack of availability. A greater awareness of RLWD on the part of physicians may have prevented these delays.
严重的鼠肺线虫病（RLWD）是一种罕见的疾病，但它可导致严重并发症，且可能难以诊断，这就需要各地的医生提高认识。我们基于夏威夷的一个病例，回顾严重RLWD的临床表现和诊断难题。一名50岁男性在食用被寄生线虫污染的生菜九天后，出现轻度头痛、肢体烧灼感、发热和排尿困难。随着时间推移，他的头痛变得更加严重，并且在甲床底部出现紫色半圆形条纹。他寻求医疗救治，但诊断被延误，这可能是由于最初的治疗医生对该疾病不熟悉所致。最终诊断基于脑脊液（CSF）证据、嗜酸性粒细胞以及CSF针对[具体病原体]的聚合酶链反应（PCR）呈阳性。皮质类固醇治疗被延误，并且由于无法获得阿苯达唑而未给药。医生对RLWD有更高的认识可能会避免这些延误。
