中国寄生虫学与寄生虫病杂志 ›› 2024, Vol. 42 ›› Issue (4): 554-556.doi: 10.12140/j.issn.1000-7423.2024.04.022

• 病例报告 • 上一篇    下一篇

山东省输入性广州管圆线虫病1例

李曰进1(), 闫燕2, 申艳梅1,3, 魏艳彬1,3, 许艳1, 王龙江1, 闫歌1, 郭云海4, 王用斌1,*()   

  1. 1 山东第一医科大学(山东省医学科学院),山东省寄生虫病防治研究所,山东 济宁 272033
    2 济宁市疾病预防控制中心,山东 济宁 272000
    3 山东第一医科大学消化病医院,山东 济宁 272033
    4 中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心),传染病溯源预警与智能决策全国重点实验室,国家卫生健康委员会寄生虫病原与媒介生物学重点实验室,世界卫生组织热带病合作中心,科技部国家级热带病国际研究中心,上海 200025
  • 收稿日期:2024-06-05 修回日期:2024-07-22 出版日期:2024-08-30 发布日期:2024-08-09
  • 通讯作者: 王用斌(1979—),男,硕士,副研究员,从事寄生虫病防控策略和技术研究。E-mail:aveo226@163.com
  • 作者简介:李曰进(1993—),男,硕士,研究实习员,从事慢性病分子流行病学与寄生虫病研究。E-mail:lyjsdfmu@163.com
  • 基金资助:
    山东省医药卫生科技发展计划(202201050165);山东省医药卫生科技发展计划(202301050242)

A case of imported angiostrongyliasis in Shandong Province

LI Yuejin1(), YAN Yan2, SHEN Yanmei1,3, WEI Yanbin1,3, XU Yan1, WANG Longjiang1, YAN Ge1, GUO Yunhai4, WANG Yongbin1,*()   

  1. 1 Shandong First Medical University & Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Diseases Control, Jining 272033, Shandong, China
    2 Jining Centre for Disease Control and Prevention, Jining 272033, Shandong, China
    3 Digestive Disease Hospital of Shandong First Medical University, Jining 272033, Shandong, China
    4 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases; Key Laboratory on Parasite and Vector Biology, Ministry of Health; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai 200025, China
  • Received:2024-06-05 Revised:2024-07-22 Online:2024-08-30 Published:2024-08-09
  • Contact: E-mail: aveo226@163.com
  • Supported by:
    Shandong Medical and Health Science and Technology Development Plan(202201050165);Shandong Medical and Health Science and Technology Development Plan(202301050242)

摘要:

患者,男,34岁,山东青岛人,保险行业职员。头痛1月余,因“头痛加重”于2023年5月31日至山东大学齐鲁医院青岛院区就诊,以颅内感染收治入院并给予阿昔洛韦、地塞米松、甘露醇等药物治疗(具体剂量不详),6月18日转诊至山东第一医科大学附属消化病医院。患者自诉曾于2023年5月1日赴云南大理旅游,期间食用螺肉,返回原籍后开始出现头痛并伴周身不适及胸闷症状。入院查体,神志清楚,站立位时头疼明显,饮食、二便正常。血常规提示外周血嗜酸粒细胞数升高(0.86 × 109/L),嗜酸粒细胞百分数升高(10.70%)。患者颅脑CT平扫结果显示,脑实质密度正常,未见异常密度影及占位病变。脑脊液及血样酶联免疫吸附试验检测结果示广州管圆线虫抗体IgG弱阳性,其余寄生虫抗体均阴性。诊断为广州管圆线虫病,给予阿苯达唑[20 mg/(kg•d),3次/d,连续口服7 d]和地塞米松[0.15 mg/(kg•d),静滴3 d]治疗。6月28日,患者头痛症状消失,嗜酸粒细胞数和百分数转归正常值,遂出院。2个月后复查,血液指标正常,广州管圆线虫IgG抗体检查呈阴性,无其他不适。

关键词: 广州管圆线虫病, 嗜酸粒细胞增多, 输入性病例

Abstract:

The patient is a 34-year-old male from Qingdao, Shandong, who works in the insurance industry. He experienced headaches for over a month and visited the Qingdao Branch of Qilu Hospital of Shandong University on May 31, 2023, due to “worsening headaches”. He was admitted for intracranial infection and treated with acyclovir, dexamethasone, and mannitol (specific doses not provided). On June 18, he was transferred to the Affiliated Hospital of Digestive Diseases of Shandong First Medical University. The patient reported travelling to Dali, Yunnan, on May 1, 2023, during which he consumed snail meat. After returning home, he began experiencing headaches, accompanied by general discomfort and chest tightness. Admitted for physical examination, he remained conscious, with significant headaches in an upright position, and had a normal diet and bowel movements. Blood routine tests showed elevated eosinophil count (0.86 × 109/L) and percentage (10.70%). A plain cranial CT scan revealed normal brain parenchyma density with no abnormal density shadows or space-occupying lesions. The ELISA results of cerebrospinal fluid and blood samples showed weakly positive IgG antibodies for Angiostrongylus cantonensis, while other parasite antibody were negative. He was diagnosed with angiostrongyliasis. He was treated with albendazole [20 mg/(kg·d), 3 times a day, continuous oral administration for 7 days] and dexamethasone [0.15 mg/(kg·d) intravenously for 3 days] for treatment. On June 28, the headache symptoms of the patient had disappeared, and his eosinophil count and percentage returned to normal values, and he was discharged. Two months later, a follow-up examination showed normal blood tests, negative IgG antibody tests for A. cantonensis, and no other discomfort.

Key words: Angiostrongyliasis, Eosinophilia, Imported cases

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