Clavel A, Bargues M D, Castillo F J, Rubio M D, Mas-Coma S
Catedra de Microbiologia y Parasitologia, Facultad de Medicina, Universidad de Zaragoza, Spain.
Am J Trop Med Hyg. 1997 Sep;57(3):317-20. doi: 10.4269/ajtmh.1997.57.317.
A 58-year-old man who was very fond of eating raw fish and had not left Zaragoza Province in Spain in the last 20 years excreted a short chain of gravid proglottids. Treatment with 50 mg/kg of paromomycin sulfate was divided into three doses, all given within the same day, followed by administration of a laxative at night. On days 1 and 2 post-treatment, several chains of degenerated proglottids were evacuated. Only eggs were expelled on days 3 and 4. A long complete strobila including the scolex, and immature, mature, and gravid segments was spontaneously discharged on day 25 after treatment. It was identified as Diplogonoporus balaenopterae, and was the first confirmed case of diplogonoporiasis outside the Far East (all previous cases were reported from Japan, except for one recent case reported from Korea). The origin of this case, outside of its normal geographic location, may be associated with the importation of fish into Spain. The viability of the infective larval stage is evidence of its resistance to export/import conditions. Treatment with paromomycin sulfate did not result in the whole worm being discharged but several short strobilar chains showed drug-induced degeneration.
一名58岁男子，非常喜欢吃生鱼，过去20年未曾离开西班牙萨拉戈萨省，他排出了一串孕节片。给予50mg/kg硫酸巴龙霉素治疗，分三次给药，均在同一天内完成，晚上再给予泻药。治疗后第1天和第2天，排出了几条退化的节片链。第3天和第4天仅排出虫卵。治疗后第25天，一条完整的长虫体包括头节、未成熟节片、成熟节片和孕节自发排出。经鉴定为须鲸双孔绦虫，这是远东地区以外首例确诊的双孔绦虫病病例（此前所有病例均来自日本，除了最近韩国报告的一例）。该病例出现在其正常地理位置以外的地方，可能与西班牙进口鱼类有关。感染性幼虫阶段的活力证明了其对进出口条件的抵抗力。硫酸巴龙霉素治疗并未使整条虫排出，但几条短的虫体链出现了药物诱导的退化。
