NEJM:传播性囊尾蚴病-病例报道

2019-03-28 xing.T 网络

在高囊肿负荷的情况下,用抗寄生虫药物治疗可以加重炎症和脑水肿,并且在眼部病变的存在下,炎症可导致视力丧失。因此,在这种情况下不给予抗寄生虫药物。

患者为一名18岁的男性,因全身强直-阵挛性癫痫发作而到急诊就诊。他的父母报告他右腹股沟疼痛了1周。

在体检时,患者感到很烦躁。他的右眼肿胀,右侧睾丸有压痛。头部的磁共振成像显示整个大脑皮层(如图A所示)和脑干和小脑(如图B所示)中有许多明确的囊性病变,这些病变与脑囊尾蚴病一致。在眼睛和右侧睾丸的超声检查中可以看到包含回声结节的明确囊肿。蛋白质印迹分析和酶联免疫吸附试验显示血清囊尾蚴病IgG抗体阳性。



在高囊肿负荷的情况下,用抗寄生虫药物治疗可以加重炎症和脑水肿,并且在眼部病变的存在下,炎症可导致视力丧失。因此,在这种情况下不给予抗寄生虫药物。

该患者尽管采用了地塞米松和抗癫痫药物治疗,患者仍在2周后死亡。

原始出处:

Nishanth Dev,et al.Disseminated Cysticercosis.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1810953

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1907358, encodeId=a368190e358ec, content=<a href='/topic/show?id=a6c425886a9' target=_blank style='color:#2F92EE;'>#传播性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25886, encryptionId=a6c425886a9, topicName=传播性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743b215, createdName=fusion, createdTime=Mon Apr 08 12:11:00 CST 2019, time=2019-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034770, encodeId=787f1034e7063, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 28 11:11:00 CST 2019, time=2019-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=363686, encodeId=c935363686d9, content=很好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Thu Mar 28 09:01:30 CST 2019, time=2019-03-28, status=1, ipAttribution=)]
    2019-04-08 fusion
  2. [GetPortalCommentsPageByObjectIdResponse(id=1907358, encodeId=a368190e358ec, content=<a href='/topic/show?id=a6c425886a9' target=_blank style='color:#2F92EE;'>#传播性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25886, encryptionId=a6c425886a9, topicName=传播性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743b215, createdName=fusion, createdTime=Mon Apr 08 12:11:00 CST 2019, time=2019-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034770, encodeId=787f1034e7063, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 28 11:11:00 CST 2019, time=2019-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=363686, encodeId=c935363686d9, content=很好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Thu Mar 28 09:01:30 CST 2019, time=2019-03-28, status=1, ipAttribution=)]
    2019-03-28 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1907358, encodeId=a368190e358ec, content=<a href='/topic/show?id=a6c425886a9' target=_blank style='color:#2F92EE;'>#传播性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25886, encryptionId=a6c425886a9, topicName=传播性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743b215, createdName=fusion, createdTime=Mon Apr 08 12:11:00 CST 2019, time=2019-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034770, encodeId=787f1034e7063, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 28 11:11:00 CST 2019, time=2019-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=363686, encodeId=c935363686d9, content=很好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Thu Mar 28 09:01:30 CST 2019, time=2019-03-28, status=1, ipAttribution=)]
    2019-03-28 thm112988

    很好的病例

    0