吉林省输入性眼部罗阿丝虫病1例

doi:10.12140/j.issn.1000-7423.2026.01.022

摘要/Abstract

摘要：

患者，男，44岁，汉族，吉林敦化人，自由职业者。患者曾因劳务原因在非洲加蓬居住5年，于2025年6月返回国内。患者因“右眼异物感及虫爬感1 d”于2025年8月9日到延边大学附属医院就诊，血常规示嗜酸粒细胞百分比为34.7%，嗜酸粒细胞计数为3.73 × 10⁹/L。眼科裂隙灯检查发现右眼球结膜下有透明丝状虫体，呈现蠕动状态；右眼结膜充血，无水肿。当日中午12时许，在局部麻醉下行结膜下寄生虫取出术，虫体位于右眼结膜颞侧，呈蜷曲状，被完整抽出。虫体由延边大学附属医院检验科及延边大学医学院寄生虫学教研室鉴定。虫体皮肤覆盖排列不规则、光滑、圆形半透明的疣状突起，子宫内含带鞘微丝蚴，形态符合文献中罗阿丝虫雌虫的描述。诊断为境外输入性罗阿丝虫病。术后于结膜囊内涂抹抗生素眼膏，予妥布霉素地塞米松滴眼液及左氧氟沙星滴眼液（各每次1滴，4次/d）。术后采集外周血，血涂片镜检均未查见微丝蚴。术后1周随访，患者按加蓬群体性驱虫方案自行服用伊维菌素片（150 μg/kg单次口服，疗程为2周）。2025年9月29日患者自行到北京友谊医院加诊复查，行丝虫抗原检测，结果为阴性。加用阿苯达唑片（0.4 g/d）口服，并定期复查血常规及肝肾功能。

关键词: 罗阿丝虫病, 眼部, 病例报告

Abstract:

The patient was a 44-year-old, self-employed, Han ethnic man residing in Dunhua City, Jilin Province. The patient had resided in Gabon, Africa for 5 years due to labor and returned to China in June 2025. On August 9, 2025, the patient visited Yanbian University Hospital with complaints of a foreign body sensation and crawling sensation in the right eye for one day. Routine blood tests showed an eosinophil percentage of 34.7% and an eosinophil count of 3.73 × 10⁹/L. Ophthalmic slit-lamp examinations identified transparent filamentous worms under the conjunctiva of the right eye, exhibiting a wriggling motion, and right eye conjunctival congestion without edema. At approximately 12: 00 on the same day, a subconjunctival parasite extraction was performed under local anesthesia, and the worm, located in the temporal side of the right eye conjunctiva and curled in shape, was completely removed, and identified by the Department Laboratory Medicine of Yanbian University Hospital and Department of Parasitology of Yanbian University Medical College. The worm surface was covered with irregular, smooth, circular, semi-transparent warty protrusions, with sheathed microfilariae in the uterus, and the parasite morphology was consistent with the description of female Loa loa in the literature. The case was diagnosed as imported loaiasis, and postoperatively given antibiotic eye ointment in the conjunctival sac, tobramycin/dexamethasone eye drops and levofloxacin eye drops (one drop each, 4 times daily). Peripheral blood was sampled postoperatively, and no microfilariae were detected in the blood smears by microscopy. A follow-up examination one week post-surgery revealed the patient had self-administered ivermectin tablets (a single oral dose of 150 μg/kg, 2-week treatment course) according to the mass deworming protocol in Gabon. On September 29, 2025, the patient voluntarily visited Beijing Friendship Hospital for a follow-up examination, where L. loa antigen tests yielded a negative result. Albendazole tablets (0.4 g/d) were additionally given, and regular monitoring of blood counts and liver/kidney function was initiated.

Key words: Loaiasis, Ocular, Case report

中图分类号:

R532.15

卢焱, 崔俊, 周福贤, 崔仁哲, 田莲姬. 吉林省输入性眼部罗阿丝虫病1例[J]. 中国寄生虫学与寄生虫病杂志, 2026, 44(1): 144-147.

LU Yan, CUI Jun, ZHOU Fuxian, CUI Renzhe, TIAN Lianji. Imported ocular loaiasis in Jilin Province: a case report[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2026, 44(1): 144-147.

图/表 2

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