疑弓首線蟲幼蟲內臓遊移症之兩病例

Two Cases of Visceral Larva Migrans Possibly Caused by Toxocara

張美惠(Mei-Hwei Chang) ； 梁德城(Der-Cherng Liang) ； 許瑞雲(Jei-Yun Hsu)

《Acta Paediatrica Sinica》 19卷1期 (1978/03) Pp. 55-59

摘要

“幼蟲內臓遊移症”乃線蟲幼蟲長期遊移於人體內臓，引起肝腫大，輕度發燒、咳嗽、哮鳴、貧血、極度嗜伊紅性白血球過多，及免疫球蛋白增高等種種臨床症狀者稱之。由於臺灣養狗與貓的人家很多，平時常與貓狗玩耍或隨地檢食的兒童，有吃入弓首線蟲(Toxocara)－亦卽狗與貓蛔蟲－的胚胎卵而引起幼蟲內臓遊移症的可能，但由於診斷上有困難，故所發現的症例不多。本文報告兩個此種病例：病例一乃3歲5個月的男孩，因嗜伊紅性白血球極度增高而住院，住院中曾發生哮喘症狀，於次日卽好轉；病例二爲5歲男孩，因皮膚發癢一個月，輕度發燒一星期，及極度嗜伊紅性白血球過多而住院。二者均有肝臓腫大，頸部淋巴腺腫，免疫球蛋白增高，以及狗與貓弓首線蟲間接螢光抗體增高的現象，經過非特異療法，情況均好轉，嗜伊紅球亦漸漸降低。

並列摘要

Visceral larva migrans is produced by the prolonged migration of nematode larvae in the internal organs of an unnatural host, usually man. It may cause hepatomegaly, mild fever, pulmonary infiltration, anemia and extreme eosinophilia. The larvae of Toxocara are the commonest causative agents. We report two cases of visceral larva migrans possibly caused by Toxocara in this paper. Case 1 was a 3-year-and-5-month-old boy with extreme eosinophilia, hepatomegaly, lymphadenopathy, hypergammaglobulinemia, and an increased titer of indirect fluorescent antibody to Toxocara. Dyspnea and wheezing occurred during admission. Chest X-ray films showed a perihilar infiltration, which improved rapidly on the next day. Case 2 was a 5-year-old boy with itching of the skin for one month duration, mild fever, easy fatigability, extreme eosinophilia, lymphadenopathy, hepatomegaly, hypergammaglobulinemia, and increased titer of indirect fluorescent antibody to Toxocara. Both two cases showed a gradual decrease of the eosinophil counts in the follow-up course of 4 to 9 months, irrespective of the treatment.

並列關鍵字

toxocara ； visceral larva migrans ； indirect fluorescent test