非典型犬弓形虫诱发的肝脏内幼虫移行症:诊断挑战与文献综述。

Tien Manh Huynh, Khanh Quoc Le Tran, Trung Hoang Dinh, Man Minh Vo, Thong Quang Pham, Thong Duy Vo
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摘要

弓形虫病是一种由犬弓形虫(来自狗)和猫弓形虫(来自猫)幼虫传播的人畜共患传染病,对人类构成罕见但严重的威胁。我们介绍了一例由犬弓形虫(Toxocara canis)引起的肝脏内脏幼虫移行症(VLM)病例,患者是一名 21 岁的男性,曾与宠物狗有过密切接触。最初的症状和影像学检查结果与化脓性肝脓肿相似。最初的实验室检查显示中性粒细胞增多和 IgE 水平升高。尽管使用了广谱抗生素,但患者仍持续发热,因此需要进一步检查。随后进行了弓形虫抗体血清学检测,肝组织的组织病理学分析显示有嗜酸性粒细胞浸润和Charcot-Leyden结晶,最终确诊为犬弓形虫引起的肝脓肿。犬弓形虫抗体血清学检测和肝组织病理学分析证实了由犬弓形虫引起的肝脓肿。阿苯达唑治疗后临床症状明显好转。该病例强调了在肝脓肿鉴别中考虑弓形虫病的必要性,尤其是在越南这样的高发病率地区。仅仅依靠血清学检测可能是不够的,因此强调需要确凿的证据,包括肝活检等侵入性程序,以准确诊断肝脏弓形虫病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Atypical Toxocara canis-Induced Hepatic Visceral Larva Migrans: Diagnostic Challenges and Literature Review.

Toxocariasis, a zoonotic infection transmitted by Toxocara canis (from dogs) and Toxocara cati (from cats) larvae, poses rare but severe risks to humans. We present a case of hepatic visceral larva migrans (VLM) caused by Toxocara canis in a 21-year-old male with a history of close contact with a pet dog. Initial symptoms and imaging findings mimicked a pyogenic liver abscess. The initial laboratory investigations revealed neutrophilia and elevated levels of IgE. Despite broad-spectrum antibiotics, persistent fever prompted further investigation. Subsequent serological testing for Toxocara antibodies and histopathological analysis of liver tissue demonstrating eosinophil infiltrates and Charcot-Leyden crystals led to a confirmed diagnosis of a liver abscess caused by Toxocara canis. Serological testing for Toxocara antibodies and histopathological analysis of liver tissue confirmed a Toxocara canis-induced liver abscess. Albendazole treatment yielded significant clinical improvement. This case highlights the necessity of considering toxocariasis in liver abscess differentials, particularly in high-seroprevalence regions like Vietnam. Relying solely on serological tests may be insufficient, emphasizing the need for corroborative evidence, including invasive procedures like liver biopsy, for accurate hepatic toxocariasis diagnosis.

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