温州市首例小儿广州管圆线虫病报告

The first case report of child angiostrongyliasis in Wenzhou

目的探讨广州管圆线虫病的诊断和治疗方法．方法分析一例２岁小儿广州管圆线虫病的发病和诊治经过．结果该病主要表现为脑脊髓膜炎，伴有面神经瘫痪，血、脑脊液中嗜酸性粒细胞明显增高，脑脊液检得第５期幼虫４３条及幼龄成虫１条；阿苯达唑辅以肾上腺皮质激素、甘露醇治疗效果良好．颅内压增高明显而脑脊液中虫体较多时，经腰穿放液减压和脑脊液灌洗、置换清除虫体减轻病情的危重性．结论脑脊液检得幼虫虫体可确诊，阿苯达唑是有效的药物，必要时进行脑脊液处置，降低颅内高压．

Objective:To identify the diagnosis and treatment of Angiostrongyliasis cantonensis in children.Metheds:The manifestation,diagnosis and treatment in an infant with Angiostrongyliasis cantonensis were analyzed.Results:It was characterized by eosinophilic meningitis accompained by myelitis and facial nerve disability.Meanwhile,severe elevated intracranail pressure and abnormal somatosensory was observed.43 larva of stage Ⅴ and one worm were collectted from CSF through lumber puncture.After Albendazol,mannitol and cortisol was employed and CSF was replaced by normal saline through lumber puncture to wash out the larva from CSF to lower intracranail pressure,the severity of patient was gradually relieved.Conclusion:Diagnosis could be made by dicovery worm from CSF.Albendazol is effective in Angiostrongylus cantonensis,especially combined with cortisol and mannitol.When intracranail pressure was markedly elevated and the larva were discovered,replacing CSF with normal saline through lumber puncture to was out the larva was also effective.