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美国西北部 4 例泡型包虫病的诊断、治疗和转归。

Diagnosis, treatment, and outcome of four dogs with alveolar echinococcosis in the northwestern United States.

机构信息

1Department of Veterinary Microbiology and Pathology, Washington Animal Disease Diagnostic Laboratory, Washington State University, Pullman, WA.

2Inland Empire Veterinary Imaging, Spokane, WA.

出版信息

J Am Vet Med Assoc. 2023 Feb 17;261(7):1-6. doi: 10.2460/javma.22.12.0540. Print 2023 Jul 1.

DOI:10.2460/javma.22.12.0540
PMID:36800299
Abstract

OBJECTIVE

To describe the clinical disease, diagnostic findings, medical management, and outcome in dogs with alveolar echinococcosis (AE).

ANIMALS

4 dogs with naturally occurring AE.

PROCEDURES

Medical records were retrospectively reviewed from 2020 to 2022 to identify dogs diagnosed with AE. Signalment, case history, clinical signs, imaging and pathological laboratory findings, treatment, and clinical outcome were reported.

RESULTS

All dogs developed systemic clinical illness and weight loss. Abdominal ultrasonography revealed multifocal to coalescent cystic masses of variable size distributed throughout the liver in all cases. Evaluation of aspirated hepatic cyst contents included membranous parasite structures and calcareous corpuscles. Echinococcus multilocularis was confirmed via PCR from hepatic cyst fluid in 3 of 4 cases. Treatment included systemic benzimidazole and praziquantel administration, 1 or more instances of ultrasound-guided cyst drainage in all cases, with ethanol ablation (percutaneous aspiration-injection-reaspiration) in 2 cases, and surgical resection in 1 case. Two of 4 dogs were euthanized within 5 months of diagnosis. One of these dogs was necropsied and had nearly complete obliteration of the hepatic parenchyma by multilocular cystic masses. One dog is still alive, and 1 dog has been lost to follow-up.

CLINICAL RELEVANCE

This series of cases highlighted the diagnostic findings and therapeutic intervention in 4 dogs with AE. This was the first report of medical management incorporating the percutaneous aspiration-injection-reaspiration method used in humans. Reports of canine AE are rare in the US, so this series serves to help raise awareness of hepatic AE in the northwestern US.

摘要

目的

描述患有泡型包虫病(AE)的犬的临床疾病、诊断结果、医学治疗和转归。

动物

4 只患有自然发生的 AE 的犬。

方法

回顾性分析 2020 年至 2022 年的病历,以确定诊断为 AE 的犬。报告了品种、病史、临床症状、影像学和病理实验室发现、治疗和临床转归。

结果

所有犬均出现全身临床疾病和体重减轻。腹部超声显示,所有病例均存在大小不一、多发至融合的囊状肿块,分布于整个肝脏。对抽吸的肝囊肿内容物进行评估,包括膜状寄生虫结构和钙质体。通过聚合酶链反应(PCR)从 4 例肝囊肿液中确认有 3 例存在多房棘球蚴。治疗包括全身使用苯并咪唑和吡喹酮,所有病例均进行 1 次或多次超声引导下的囊肿引流,其中 2 例进行乙醇消融(经皮抽吸-注射-再抽吸),1 例进行手术切除。4 只犬中有 2 只在诊断后 5 个月内被安乐死。其中 1 只进行了剖检,肝脏实质几乎被多房囊性肿块完全破坏。1 只犬仍存活,1 只犬失访。

临床相关性

本系列病例强调了 4 只 AE 犬的诊断结果和治疗干预。这是首次报道在人类中使用经皮抽吸-注射-再抽吸方法进行的医学治疗。美国报道的犬 AE 病例很少,因此本系列病例有助于提高美国西北部对肝 AE 的认识。

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