Barra L A, dos Santos W F, Chieffi P P, Bedaque E A, Salles P S, Capitão C G, Vianna S, Hanna R, Pedretti Júnior L
Instituto de Infectologia Emílio Ribas, Instituto de Medicina Tropical de São Paulo, Brasil.
Rev Soc Bras Med Trop. 1996 Jul-Aug;29(4):373-6. doi: 10.1590/s0037-86821996000400011.
We relate a case of an 18-year-old man, resident of Xapuri (state of Acre, Brazil), with a history of repeated episodes of meningoencephalitis (three in one year), each one was examined by a local doctor. In our service (Emílio Ribas Institute of Infectology) we observed a patient with polyjoint aches, radiological and bronchoscopic pulmonary alterations (without clinical features), meningeal and brain stem manifestations--with normal brain computed tomography and cerebrospinal fluid. Blood eosinophils and serological Toxocara canis test (ELISA) were greatly increased. With the hypothesis of Toxocariasis (visceral larva migrans) we administered thiabendazole that brought complete clinical and laboratory remission. Inspite of a new episode of headache with meningeal manifestation approximately one month later (treated with dexamethasone resulting in a full remission after three days) we have not found other manifestations in approximately three and a half years of ambulatory care.
我们讲述了一名18岁男性的病例，该患者来自巴西阿克里州的沙普里，有反复发生的脑膜脑炎病史（一年内发作三次），每次发作都由当地医生进行检查。在我们的科室（埃米利奥·里巴斯传染病研究所），我们观察到一名患者有多个关节疼痛、放射学和支气管镜检查显示肺部有改变（无临床症状）、脑膜和脑干表现，而脑部计算机断层扫描和脑脊液检查结果正常。血液嗜酸性粒细胞和犬弓首线虫血清学检测（酶联免疫吸附测定）结果大幅升高。基于内脏幼虫移行症（弓蛔虫病）的假设，我们给予了噻苯达唑治疗，患者临床和实验室检查结果完全缓解。尽管大约一个月后又出现了一次伴有脑膜表现的头痛发作（用地塞米松治疗，三天后完全缓解），但在大约三年半的门诊治疗期间，我们未发现其他症状。
