NEJM:椎骨包虫病-病例报道

2018-07-12 xing.T MedSci原创

棘球绦虫是一种寄生绦虫,可以感染狗和其他宠物以及农场动物,人类是其偶然寄主。感染可引起肝脏、肺部、中枢神经系统和骨骼的囊性病变。

患者为一名35岁的女性,因虚弱无力、双腿电击感和反复跌倒而被送往急诊就诊。她报告症状一直在进展,她在3个月前骑马时感觉到了困难。一直住在法国,没有外国旅行史,饲养一只宠物猫,并经常与牛接触。

体格检查显示双腿感觉受损,脚部屈曲无力。实验室检查显示白细胞总数增加(18800/mm3;参考范围为4000-10000/mm3),绝对嗜酸性粒细胞计数正常,C反应蛋白水平为49mg/L(参考值<5)。脊柱磁共振成像显示第9胸椎分叶状病变,含有硬膜外(如图A所示,箭头处的特写图像展示在图B中)。手术治疗包括第9胸椎后路椎体切除术,第7至第11胸椎骨接合术,切除硬膜外病变。病理检查揭示为囊性棘球蚴病(包虫病),逆转录酶-聚合酶链反应检测发现细粒棘球绦虫。



棘球绦虫是一种寄生绦虫,可以感染狗和其他宠物以及农场动物,人类是其偶然寄主。感染可引起肝脏、肺部、中枢神经系统和骨骼的囊性病变。

除手术外,该患者还接受了抗寄生虫药物阿苯达唑治疗。在就诊后9个月的随访中,患者没有残留症状或复发迹象。

原始出处:

Marine Jacquier, et al.Vertebral Hydatidosis.N Engl J Med 2018;https://www.nejm.org/doi/full/10.1056/NEJMicm1714206

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

评论区 (3)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1604928, encodeId=664a160492806, content=<a href='/topic/show?id=513a33462cb' target=_blank style='color:#2F92EE;'>#包虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33462, encryptionId=513a33462cb, topicName=包虫病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=121819300669, createdName=ms5822920152752585, createdTime=Fri Jul 13 22:27:00 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331340, encodeId=54553313400b, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Jul 13 18:24:44 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331016, encodeId=7a7733101606, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jul 12 07:49:39 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1604928, encodeId=664a160492806, content=<a href='/topic/show?id=513a33462cb' target=_blank style='color:#2F92EE;'>#包虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33462, encryptionId=513a33462cb, topicName=包虫病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=121819300669, createdName=ms5822920152752585, createdTime=Fri Jul 13 22:27:00 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331340, encodeId=54553313400b, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Jul 13 18:24:44 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331016, encodeId=7a7733101606, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jul 12 07:49:39 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-13 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1604928, encodeId=664a160492806, content=<a href='/topic/show?id=513a33462cb' target=_blank style='color:#2F92EE;'>#包虫病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33462, encryptionId=513a33462cb, topicName=包虫病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=121819300669, createdName=ms5822920152752585, createdTime=Fri Jul 13 22:27:00 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331340, encodeId=54553313400b, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Jul 13 18:24:44 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331016, encodeId=7a7733101606, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Jul 12 07:49:39 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-12 龙胆草

    学习谢谢分享

    0

相关资讯

JNS:最上端融合椎的节段决定交界性后凸的类型

临床对于各类复杂脊柱畸形实施矫形手术时,常需行跨腰骶椎长节段固定融合。脊柱长节段固定融合对于脊柱畸形具有良好的三维矫形效果,但由于脊柱腰骶部及骶髂关节局部独特的解剖结构和复杂的生物力学特征,使得腰-骶-骨盆区域的手术内固定治疗成为脊柱外科的难题。 脊柱长节段固定至骶椎的临床患者,远端固定融合区域常由于骶骨螺钉松动或拔出而导致内固定失败。由于融合节段的正确选择是手术成功的关键,选择不当会引起术后效