山东省输入性广州管圆线虫病1例  

A case of imported angiostrongyliasis in Shandong

作　　者：李曰进 闫燕 申艳梅 魏艳彬 许艳 王龙江 闫歌 郭云海 王用斌 LI Yuejin;YAN Yan;SHEN Yanmei;WEI Yanbin;XU Yan;WANG Longjiang;YAN Ge;GUO Yunhai;WANG Yongbin(Shandong First Medical University&Shandong Academy of Medical Sciences,Shandong Institute of Parasitic Diseases Control,Jining 272033,Shandong,China;Jining Centre for Disease Control and Prevention,Jining 272033,Shandong,China;Digestive Disease Hospital of Shandong First Medical University,Jining 272033,Shandong,China;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)

机构地区：[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

出　　处：《中国寄生虫学与寄生虫病杂志》2024年第4期554-556,共3页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：山东省医药卫生科技发展计划(202201050165,202301050242)。

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(0.86×10^(9)/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。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(0.86×10^(9)/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 treat‑ment.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.

关 键 词：广州管圆线虫病 嗜酸粒细胞增多 输入性病例 

分 类 号：R532.1[医药卫生—内科学]