生食蛇胆后反复自发性气胸1例

Repeated pneumothorax caused by ingestion of uncooked snake gall

目的：多种寄生虫感染在自然界中普遍存在，食源性寄生虫感染为一人兽共患疾病，威胁着人类的健康。本文通过对生食蛇胆后引起反复自发性气胸的讨论，以提高临床医师对食源性寄生虫感染的警惕性，避免误诊和漏诊。方法本文报道了1例女性20岁患者反复出现咳嗽、胸闷伴胸痛3月余；有生食蛇胆史；胸片及CT提示气胸，住院期间气胸反复发作；肺、肝、血吸虫抗体阳性；血常规及骨穿提示嗜酸粒细胞增多症。结果经吡喹酮、替硝唑、阿苯达唑治疗后，嗜酸粒细胞数逐渐下降，症状逐渐好转。结论以自发性气胸为首发症状的多种寄生虫感染很少见，因此应仔细询问流行病史以避免造成误诊或漏诊。

Objective Infections by multiple parasite species are coramon in nature. Food borne parasitic infection is a zoonosis affecting human beings. The aim of our case report is to improve the vigilance of clinician in order to avoid misdiagnosis or missed diagnosis. Melhods A 20 years old female patient presented with a three month history of repeated dry cough, tightness and chest pain. She had history of ingestion of uncooked snake gall. Chest X-ray revealed pneumothorax. During hospitalization, she presented repeated pneumothorax. Serum antibody of Paragonimus westermani, liver fluke and schistosome were positive. Blood routine examination and osteostixis revealed peripheral blood eosinophilia. Results After treatment with praziquantel, tinidazole and albendazole, there was downturn in the number of eosinophils and the symptoms improved. Conclusions Multiple parasitic infection started with pneumothorax symptoms is rare, therefore, we must be careful in inquiring epidemic to avoid misdiagnosis or missed diagnosis.