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17 年颅内裂头蚴存活患者的外科治疗。

Surgical treatment of a patient with live intracranial sparganosis for 17 years.

机构信息

Department of Emergency Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.

Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.

出版信息

BMC Infect Dis. 2022 Apr 9;22(1):353. doi: 10.1186/s12879-022-07293-7.

Abstract

BACKGROUND

The incidence of sparganosis, especially intracranial live sparganosis is very low in China. Due to the lack of typical clinical manifestations, it is difficult to make a clear preoperative diagnosis of the disease, which often leads to delays the disease and serious consequences.

CASE PRESENTATION

A 23-year-old man presented with a 17-year history of intermittent seizures and right extremity numbness and weakness. Magnetic resonance imaging (MRI) showed patchy, nodular and line-like enhancement. Enzyme-linked immunosorbent assay (ELISA) detected positive antibodies to Spirometra mansoni in peripheral blood and cerebrospinal fluid (CSF). In addition, during the operation, an ivory-colored live sparganosis was removed under the precise positioning of neuronavigation, and the patient was diagnosed with cerebral sparganosis. The patient began praziquantel and sodium valproate treatment after the operation, and was followed up for 3 months. There was no recurrence of epilepsy, and the weakness and numbness of the right limb improved.

CONCLUSION

Nonspecific clinical manifestations often make the diagnosis of cerebral sparganosis difficult, and a comprehensive diagnosis should be made based on epidemiological history, clinical manifestations, ELISA results and imaging findings. Surgery is the preferred method for the treatment of cerebral sparganosis, and more satisfactory results can be achieved under the precise positioning of neuronavigation.

摘要

背景

在中国,曼氏迭宫绦虫裂头蚴病的发病率,尤其是颅内活裂头蚴病的发病率非常低。由于缺乏典型的临床表现,术前很难明确诊断该疾病,这往往导致疾病的延误和严重后果。

病例介绍

一名 23 岁男性,间歇性癫痫发作 17 年,右侧肢体麻木无力。磁共振成像(MRI)显示斑片状、结节状和线状强化。酶联免疫吸附试验(ELISA)检测到外周血和脑脊液(CSF)中曼氏迭宫绦虫阳性抗体。此外,在手术过程中,在神经导航的精确定位下切除了乳白色的活裂头蚴,患者被诊断为脑裂头蚴病。术后患者开始使用吡喹酮和丙戊酸钠治疗,并随访 3 个月。癫痫无复发,右侧肢体无力和麻木改善。

结论

非特异性临床表现常使脑裂头蚴病的诊断困难,应根据流行病学史、临床表现、ELISA 结果和影像学表现进行综合诊断。手术是治疗脑裂头蚴病的首选方法,在神经导航的精确定位下可取得更满意的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d8d/8994396/e856d68e55a0/12879_2022_7293_Fig1_HTML.jpg

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