Colonoscopic Diagnosis of Ancylosto Ma Ceylanicum Infection: Report of a Case

大腸鏡診斷錫蘭鉤蟲感染症：一病例報告

林政寬(Cheng-Kuan Lin) ； 廖俊星(Chun-Hsing Liao) ； 蘇霩靄(Kua-Eyre Su) ； 李宗熙(Tzong-Hsi Lee)

《臺灣消化醫學雜誌》 26卷1期 (2009/03) Pp. 21-26

https://doi.org/10.6557/GJT.200903_26(1).0004

摘要

錫蘭鉤蟲爲一種少見的人畜共通寄生蟲，由狗貓宿主傳染給人類，而引起腹痛、腹瀉、貧血等症狀。我們報告一位44歲男性病患，可能因接觸流浪狗而得到錫蘭鉤蟲感染，其症狀爲持續腹瀉、腹部悶痛、血便等現象，血中嗜伊紅性白血球數目增加，但糞便中未驗出寄生蟲卵，大腸鏡檢查發現自橫結腸至昇結腸及終端迴腸黏膜皆有多發性糜爛破皮，可見已吸血會動之蟲體存在。經使用切片夾取出蟲體鑑定爲錫蘭鉤蟲，之後使用mebendazole治療三日，由糞便中收集的雌蟲體內也未發現蟲卵。病患症狀於治療後改善，一個月後糞便檢查未再發現有蟲體或是蟲卵。因此在台灣與狗貓親密接觸者，若有腹痛、腹瀉甚至血便時，須留意錫蘭鉤蟲感染的可能性，若糞便檢查仍無法得到確診時可考慮實施大腸鏡的檢查。

關鍵字

錫蘭鉤蟲 ； 鉤蟲感染 ； 大腸鏡檢查

並列摘要

Ancylostoma ceylanicum is a rare zoonotic parasite normally found in dogs and cats. The hookworm infection causes abdominal pain, diarrhea, or anemia. Herein, we report the case of a 44-year-old male who suffered from persistent diarrhea, abdominal pain, and bloody stool due to A. ceylanicum infection, possibly transmitted from stray dogs. Hemogram revealed eosinophilia, but no parasite ova were found in the stool. Colonoscopy revealed mobile, blood-filled worms from the transverse to the ascending colon and terminal ileum accompanied by multiple mucosal erosions. The worms were caught by biopsy forceps and were identified as A. ceylanicum by morphologic characteristics. The patient was treated with mebendazole for three days. His symptoms subsided after treatment and no more parasites or ova were detected in the stool one month later. Hence, A. ceylanicum infection should be kept in mind in humans in Taiwan that have close contact with dogs or cats who show symptoms of abdominal pain, diarrhea, or even bloody stool. Diagnosis by colonoscopy is considered if fecal examination is inconclusive.

並列關鍵字

ancylostoma ceylanicum ； hookworm infection ； colonoscopy