개회충증에 의하여 유발된 호산구성 심장막염을 동반한 급성 담낭염 1예
A Case of Acute Cholecystitis Combined with Eosinophilic Pericarditis Caused by Toxocariasis
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초록
개회충증 감염은 동물에 의해 토양으로 배설된 충란이나유충이 경구로 섭취되거나 유충에 감염된 숙주의 내장을 직접 날것으로 먹었을 때 감염되며 충란이 장내에서 유충으로부화하고 장벽을 침윤하여 순환하는 혈액을 따라 내장기관을 침범하고 염증반응을 일으키면서 임상적 증상을 유발한다. 본 증례는 심장막염이 동반된 급성 담낭염 환자로 호산구증가증이 동반되어 기생충 감염을 의심할 수 있었지만, 일반적인 분변 검사를 통해 원인 감별이 어려웠고, ELISA를통한 면역혈청학적 검사를 통해 개회충증을 진단하고 치료후 임상적인 호전을 보였다. 개회충증으로 인한 호산구증가증과 관련하여 급성 담낭염 및 심막염이 발생한 드문 증례로 문헌고찰과 함께 보고하는 바이다.
Abstract
Toxocariasis is a parasite infection of a human host caused by Toxocara canis. Most human infections occur in persons who eat contaminated food containing embryonated eggs or larvae. Toxocariasis can produce various symptoms associated with eosinophilic infiltration into various internal organs such as the liver, lungs, eyes, or central nervous system. However, a simultaneous onset of cholecystitis and pericarditis has not yet been reported in the literature. A 39-year-old female patient complained of right upper abdominal pain. Several imaging studies revealed acute cholecystitis and pericarditis with pericardial effusion. Marked eosinophilia was observed in her peripheral blood and pericardial fluid. A high titer of antibodies against T. canis was discovered during the search for the cause of the eosinophilia. All clinical features and the eosinophilia improved dramatically after treatment with albendazole. We report a case of simultaneous onset of acute cholecystitis and pericarditis associated with marked eosinophilia caused by T. canis.
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