克服地域限制:非流行地区阿米巴肝脓肿的诊断和治疗挑战。

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Experimental Gastroenterology Pub Date : 2024-07-09 eCollection Date: 2024-01-01 DOI:10.2147/CEG.S459696
Bogusz Aksak-Wąs, Malwina Karasińska-Cieślak, Miłosz Parczewski
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引用次数: 0

摘要

本病例报告提供了非流行地区阿米巴病诊断和治疗所面临的独特挑战的相关数据。本病例报告的重点是一名暂居波兰的 28 岁印度裔男性患者,他被诊断出患有阿米巴肝脓肿。患者出现一系列非特异性症状,包括气短、胸痛和发热。鉴别诊断包括心肺疾病、一系列热带疾病(如疟疾或伤寒)、细菌性脓肿和恶性肿瘤,因此有必要采取全面、多模式的诊断方法。这种方法包括对患者病史、体格检查以及各种实验室和影像学检查的广泛回顾。该病例面临的另一个挑战是波兰没有标准的囊肿治疗方法,因此需要采取个性化的治疗策略。尽管存在这些障碍,该患者还是成功地接受了由甲硝唑、头孢曲松、强力霉素、氯喹和三甲双胍/磺胺甲噁唑组成的替代治疗方案(甲硝唑治疗是基础药物,由于缺乏典型的杀囊肿治疗药物,因此增加了一种替代治疗药物:氯喹是一种推荐用于治疗妊娠患者的药物,此外,强力霉素在体外对恩塔莫阿米巴组织溶解菌有活性)。这一治疗历程凸显了治疗方案适应性的价值,尤其是在某些资源可能不易获得的地区。本病例报告强调了在非流行病地区扩大鉴别诊断范围以包括热带疾病的重要性,尤其是在全球旅行和移民日益增多的情况下。报告还强调了在这种情况下采用综合诊断策略和适应性治疗方案的重要性。此外,报告还重申,医疗服务提供者之间需要开展全球合作和教育,以有效管理热带疾病,尤其是在非流行地区。本报告通过探讨在非流行地区诊断和管理阿米巴病的复杂性,为全球临床医生提供了宝贵的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Overcoming Geographical Constraints: A Diagnostic and Therapeutic Challenge of Amebic Liver Abscess in a Non-Endemic Region.

This case report provides data on unique challenges related to amoebiasis diagnostics and treatment in non-endemic regions. The presented case report is focused a 28-year-old male patient of Indian origin, temporarily living in Poland, who was diagnosed with an amoebic liver abscess. The patient presented with a range of non-specific symptoms including shortness of breath, chest pain, and fever. The differential diagnosis included cardio-pulmonary diseases, a range of tropical diseases such as malaria or typhoid fever, bacterial abscesses, and malignancies, necessitating a comprehensive, multi-modal diagnostic approach. This approach included an extensive review of patient history, physical examination, and various laboratory and imaging investigations. A further challenge in this case was the unavailability of standard cysticidal treatments in Poland, which required individualized therapeutic strategy. Despite these obstacles, the patient was successfully treated using an alternative regimen of intravenous metronidazole, ceftriaxone, doxycycline, chloroquine, and finally, trimethoprim/sulfamethoxazole (treatment with metronidazole was used as a base drug, due to the lack of typical cysticidal treatment, an alternative treatment was added: chloroquine is a recommended drug used in the treatment of pregnant patients, in addition, doxycycline showed in vitro activity against Entamoeba histolytica). This therapeutic journey underscored the value of adaptability in treatment protocols, particularly in regions where certain resources may not be readily available. This case report underlines the importance of broadening the differential diagnosis in non-endemic regions to include tropical diseases, particularly in the context of increasing global travel and migration. It also highlights the significance of employing comprehensive diagnostic strategies and adaptable treatment protocols in such scenarios. In addition, the report reiterates the need for global collaboration and education among healthcare providers to effectively manage tropical diseases, especially in non-endemic regions. Through its exploration of the complexities associated with diagnosing and managing amebiasis in a non-endemic region, this report offers valuable insights to clinicians worldwide.

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来源期刊
Clinical and Experimental Gastroenterology
Clinical and Experimental Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.10
自引率
0.00%
发文量
26
审稿时长
16 weeks
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