病例报告

吉林省输入性眼部罗阿丝虫病1例

  • 卢焱 ,
  • 崔俊 ,
  • 周福贤 ,
  • 崔仁哲 ,
  • 田莲姬
展开
  • 1 延边大学附属医院眼科, 吉林延吉 133000
    2 延边大学附属医院检验科, 吉林延吉 133000
卢焱,女,技师,从事眼科诊治工作。E-mail:59660458@qq.com
* 田莲姬(ORCID:0000-0003-4292-2735),女,博士,主治医师,从事眼科诊治工作。E-mail:16360952@qq.com

收稿日期: 2025-08-18

  修回日期: 2026-01-07

  网络出版日期: 2026-02-24

Imported ocular loaiasis in Jilin Province: a case report

  • LU Yan ,
  • CUI Jun ,
  • ZHOU Fuxian ,
  • CUI Renzhe ,
  • TIAN Lianji
Expand
  • 1 Department of Ophthalmology, Yanbian University Hospital, Yanji 133000, Jilin, China
    2 Department of Laboratory Medicine, Yanbian University Hospital, Yanji 133000, Jilin, China

Received date: 2025-08-18

  Revised date: 2026-01-07

  Online published: 2026-02-24

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。

本文引用格式

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 . DOI: 10.12140/j.issn.1000-7423.2026.01.022

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

参考文献

[1] 顾雪如, 沈丽英. 援非人员皮下获得的罗阿丝虫成虫形态观察[J]. 浙江医学, 1980, 2(4): 35-36.
  Gu XR, Shen LY. Morphological observation of adult Filaria loa obtained subcutaneously by aid workers in Africa[J]. Zhejiang Med J, 1980, 2(4): 35-36. (in Chinese)
[2] Cho HY, Lee YJ, Shin SY, et al. Subconjuctival Loa loa with Calabar swelling[J]. J Korean Med Sci, 2008, 23(4): 731-733.
[3] 蔡祺, 叶乃芳, 艾琳, 等. 上海市1例输入性罗阿丝虫病的临床特征与诊断[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(4): 370-374.
  Cai Q, Ye NF, Ai L, et al. Clinical features and diagnosis of an imported loiasis patient in Shanghai[J]. Chin J Parasitol Parasit Dis, 2018, 36(4): 370-374. (in Chinese)
[4] Boussinesq M, Gardon J, Gardon-Wendel N, et al. Clinical picture, epidemiology and outcome of Loa-associated serious adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon[J]. Filaria J, 2003, 2(Suppl 1): S4.
[5] Zouré HG, Wanji S, Noma M, et al. The geographic distribution of Loa loa in Africa: results of large-scale implementation of the rapid assessment procedure for loiasis (RAPLOA)[J]. PLoS Negl Trop Dis, 2011, 5(6): e1210.
[6] 许翔, 姚立农, 章金阳, 等. 输入性罗阿丝虫病1例报告[J]. 中国病原生物学杂志, 2008, 3(12): 926.
  Xu X, Yao LN, Zhang JY, et al. One case of imported loiasis[J]. J Pathog Biol, 2008, 3(12): 926. (in Chinese)
[7] Baartman BJ, Nguyen L, Wiest P, et al. Ocular loiasis in Ohio: a case report[J]. Int Ophthalmol, 2018, 38(5): 2167-2170.
[8] 王蔼青. 罗阿丝虫(附四例报告)[J]. 眼科研究, 1983, 1(3): 173-174.
  Wang AQ. Filariasis (report of four cases)[J]. Chin Ophthalmic Res, 1983, 1(3): 173-174. (in Chinese)
[9] Kamgno J, Kamtchum-Tatuene J, Esso L, et al. A cross-sectional investigation of the ophthalmological impact of loiasis in Cameroon, Central Africa[J]. PLoS Negl Trop Dis, 2025, 19(6): e0013216.
[10] 何战英, 王小梅, 李锡太, 等. 北京市5例输入性罗阿丝虫病流行病学特征分析[J]. 热带病与寄生虫学, 2016, 14(2): 74-76.
  He ZY, Wang XM, Li XT, et al. Imported loaiasis in Beijing: epidemiological characteristics in 5 patients[J]. J Trop Dis Parasitol, 2016, 14(2): 74-76. (in Chinese)
[11] 叶亚君, 阮卫, 王笑笑, 等. 杭州市首例境外输入性罗阿丝虫病病例报告[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(6): 729-730.
  Ye YJ, Ruan W, Wang XX, et al. Report on the first imported case of filariasis in Hangzhou[J]. Chin J Parasitol Parasit Dis, 2020, 38(6): 729-730. (in Chinese)
[12] 张家祺, 阮卫, 王笑笑, 等. 浙江省1例输入性罗阿丝虫病的诊断与病原学鉴定[J]. 中国病原生物学杂志, 2021, 16(4): 446-449.
  Zhang JQ, Ruan W, Wang XX, et al. Diagnosis and etiological identification of an imported case of loiasis[J]. J Parasit Biol, 2021, 16(4): 446-449. (in Chinese)
[13] Kalbitz S, Grünewald T. Loiasis[J]. N Engl J Med, 2021, 385(10): e28.
[14] Luo XC, Li S, Li Q, et al. Atypical imported loiasis characterised by recurrent anaemia in a patient from China[J]. Lancet Infect Dis, 2022, 22(2): 295.
[15] 罗晓成, 陶志勇. 罗阿丝虫病实验室诊断方法的研究进展[J]. 内科, 2023, 18(1): 52-56, 77.
  Luo XC, Tao ZY. Research progress in laboratory diagnostic methods for loiasis[J]. Intern Med, 2023, 18(1): 52-56, 77. (in Chinese)
[16] Metzger WG, Mordmüller B. Loa loa: Does it deserve to be neglected?[J]. Lancet Infect Dis, 2014, 14(4): 353-357.
[17] Pinder M. Loa loa: a neglected Filaria[J]. Parasitol Today, 1988, 4(10): 279-284.
[18] Carme B. Variations in microfilaremia in Loa loa filariasis[J]. Ann Soc Belg Med Trop, 1983, 63(4): 333-339.
[19] Touré FS, Mavoungou E, Kassambara L, et al. Human occult loiasis: field evaluation of a nested polymerase chain reaction assay for the detection of occult infection[J]. Trop Med Int Health, 1998, 3(6): 505-511.
[20] 邹洋, 王磊, 王非, 等. 11例输入性罗阿丝虫病临床特征分析[J]. 中国病原生物学杂志, 2017, 12(3): 274-277.
  Zou Y, Wang L, Wang F, et al. Imported Loa loa filariasis: a retrospective analysis of 11 cases[J]. J Parasit Biol, 2017, 12(3): 274-277. (in Chinese)
[21] Ramharter M, Butler J, Mombo-Ngoma G, et al. The African eye worm: current understanding of the epidemiology, clinical disease, and treatment of loiasis[J]. Lancet Infect Dis, 2024, 24(3): e165-e178.
[22] Lipner EM, Law MA, Barnett E, et al. Filariasis in travelers presenting to the GeoSentinel surveillance network[J]. PLoS Negl Trop Dis, 2007, 1(3): e88.
[23] 张活文, Edjang C. 眼部罗阿丝虫病39例临床观察[J]. 临床眼科杂志, 2003, 11(1): 63-64.
  Zhang HW, Edjang C. Clinical observation on 39 cases of ocular filariasis[J]. J Clin Ophthalmol, 2003, 11(1): 63-64. (in Chinese)
[24] 甘绍伯. 罗阿丝虫病[J]. 中国热带医学, 2009, 9(10): 1961-1962.
  Gan SB. Loiasis[J]. China Trop Med, 2009, 9(10): 1961-1962. (in Chinese)
[25] Gobbi F, Buonfrate D, Tamarozzi F, et al. Efficacy of high-dose albendazole with ivermectin for treating imported loiasis, Italy[J]. Emerg Infect Dis, 2019, 25(8): 1574-1576.
[26] 何静, 刘荣堂, 刘增加. 我国虻科研究进展[J]. 中华卫生杀虫药械, 2006, 12(4): 248-252.
  He J, Liu RT, Liu ZJ. Research progress of Tabanidae in China[J]. Chin J Hyg Insectic Equip, 2006, 12(4): 248-252. (in Chinese)
[27] 邢安辉, 刘国平, 任清明, 等. 我国东北三省虻科昆虫的种类和区系分布研究[J]. 中华卫生杀虫药械, 2013, 19(2): 141-146.
  Xing AH, Liu GP, Ren QM, et al. Species and fauna distribution of Tabanidae in three provinces of Northeast China[J]. Chin J Hyg Insectic Equip, 2013, 19(2): 141-146. (in Chinese)
[28] 何静, 刘增加, 徐宏江. 青海省双翅目虻科昆虫研究[J]. 中国媒介生物学及控制杂志, 2016, 27(6): 573-576.
  He J, Liu ZJ, Xu HJ. Study on the gadfly in Qinghai Province (Diptera : Tabanidae)[J]. Chin J Vector Biol Control, 2016, 27(6): 573-576. (in Chinese)
文章导航

/

〈 〉