Østerhus Ingvild Nesse, Lier Tore, Steineger Johan Edvard, Martinsen Karen Helene Bronken, Aronsen Hanna Høyem, Alfonso Jose Hernán
Øre-nese-halsavdelingen, Klinikk for hode-, hals- og rekonstruktiv kirurgi, Oslo universitetssykehus.
Referansetjenesten for serologisk parasittdiagnostikk, Avdeling for mikrobiologi og smittevern, Universitetssykehuset Nord-Norge.
Tidsskr Nor Laegeforen. 2023 Mar 2;143(4). doi: 10.4045/tidsskr.22.0434. Print 2023 Mar 14.
A young boy presented with acute ethmoiditis and recurrent periorbital swelling. The periorbital swelling was confirmed to be caused by a rare condition.
Debut symptoms were acute rhinitis, unilateral periorbital swelling, fatigue, and swelling in the temple region, probably caused by an insect bite. Magnetic resonance imaging (MRI) of the sinuses showed bilateral ethmoiditis and unilateral periorbital cellulitis without subperiostal abscess formation, and antibiotics were prescribed. Because of recurrence of the periorbital swelling, an interdisciplinary team started an investigation for a differential diagnosis. The infestation of Hypoderma tarandi was confirmed by recent history of hiking in reindeer habitat, typical clinical presentation and detection of IgG hypodermin C antibodies.
Human myiasis by Hypoderma tarandi is a rare condition in Norway. Typical clinical signs are unaffected general condition, migration of swelling in the forehead, recurrent unilateral periorbital swelling and normal CRP levels. Early-stage diagnosis and treatment will contribute to rapid symptom relief and prevent rare eye and intracranial complications. This case illustrates the importance of investigation for other conditions when the disease course is unexpected. The authors emphasise that knowledge about this disease is important in a variety of medical specialties.
一名小男孩出现急性筛窦炎和反复眶周肿胀。经证实，眶周肿胀是由一种罕见病症引起的。
首发症状为急性鼻炎、单侧眶周肿胀、疲劳以及颞部肿胀，可能由昆虫叮咬所致。鼻窦磁共振成像（MRI）显示双侧筛窦炎和单侧眶周蜂窝织炎，无骨膜下脓肿形成，遂开具了抗生素。由于眶周肿胀复发，一个跨学科团队展开调查以进行鉴别诊断。通过近期在驯鹿栖息地徒步旅行的病史、典型临床表现以及检测到抗Hypodermin C IgG抗体，确诊为驯鹿皮蝇幼虫感染。
在挪威，驯鹿皮蝇幼虫所致的人体蝇蛆病是一种罕见病症。典型的临床体征包括一般状况未受影响、前额肿胀迁移、反复单侧眶周肿胀以及C反应蛋白（CRP）水平正常。早期诊断和治疗有助于迅速缓解症状，并预防罕见的眼部和颅内并发症。该病例说明了当病程出人意料时对其他病症进行调查的重要性。作者强调，了解这种疾病在多个医学专科中都很重要。
