一例犬肝吸虫感染的病例报告

A case report of canine liver fluke infection

成年、雄性已绝育柯基犬,就诊前近半个月反复呕吐、腹泻,在其他宠物医院对症治疗无明显改善。为了对该病例进行诊治,采取临床检查、血液学检查、粪便直接镜检及影像学检查进行诊断,并根据诊断结果进行治疗。结果表明:患犬嗜酸性粒细胞增多,提示过敏、炎性疾病或寄生虫感染;丙氨酸氨基转移酶、天门冬氨酸氨基转移酶活性升高,提示存在肝细胞损伤;碱性磷酸酶活性及γ-谷氨酰转肽酶活性升高,提示存在胆汁淤积;B型超声波检查发现肝实质内高回声亮点。初诊怀疑胆管炎,对症治疗无明显改善;复诊结合粪便中检出吸虫卵,最终确诊为肝吸虫感染。使用吡喹酮及对症治疗后,患犬症状改善,恢复良好。说明犬肝吸虫发病隐蔽,应引起临床医生的重视以避免漏诊或误诊。

An adult male sterilized Corgi presented repeated vomiting and diarrhea which had lasted half a month before visiting doctor, and had no obvious improvement under symptomatic treatment in other hospitals. In order to carry out diagnosis and treatment for this case, clinical examination, hematological examination, direct stool microscopy and imaging examination were conducted for diagnosis;the treatment was carried out according to the diagnosis results. The results showed that eosinophilia of the dog appeared, which indicated allergy, inflammatory disease or parasitic infection. The activity of glutamate transferase and aspartate transferase was increased, which indicated liver cell injury. The activity of alkaline phosphatase and γ-glutamyl transpeptidase was increased, indicating the presence of cholestasis. B-type ultrasound examination found that hyperechoic highlights in the liver parenchyma. Preliminary diagnosis was suspected as cholangitis, but no obvious improvement was found in symptomatic treatment. Further consultation combined with detecting fluke eggs in feces had a final confirmed diagnosis as liver fluke infection. After using praziquantel for symptomatic treatment, the sick dog’s symptom improved and it recovered well. The results suggested that the occurrence of canine liver fluke was hidden, to which attention should be paid by clinicians to avoid missed diagnosis or misdiagnosis.