PDF(Pubmed)
Abstract：
UNASSIGNED: Anisakis infects humans by consuming contaminated undercooked or raw fish, leading to gastric anisakiasis, gastro-allergic anisakiasis, or asymptomatic contamination. Although larvae usually die when penetrating the gastric tissue, cases of intra- and extra-abdominal spread were described. We report the first probable case of pericardial anisakiasis.
UNASSIGNED: A 26-year-old man presented to the emergency department because of progressive lower limb oedema and exertional dyspnoea. Two months prior, he had consumed raw fish without any gastrointestinal symptoms. The echocardiogram reported a circumferential pericardial effusion (\'swinging heart\') and mildly reduced left ventricular ejection fraction (LVEF). He was diagnosed with myopericarditis after a cardiac magnetic resonance. A fluorodeoxyglucose positron emission tomography scan revealed an intense pericardial metabolism. Blood tests exhibited persistent eosinophilia and mild elevation of Anisakis simplex IgE-as for past infestation. A pericardial drainage was performed, subsequently, serial echocardiograms revealed a spontaneous recovery of his LVEF. No autoimmune, allergic, or onco-haematologic diseases were identified. Based on a history of feeding with potentially contaminated raw fish and on long-lasting eosinophilia, we suspected a pericardial anisakiasis, despite a low but persistent titre of specific IgE. Albendazole was administered for 21 days, along with colchicine and ibuprofen for 2 months; pericardial effusion resolution and eosinophil normalization occurred two weeks after.
UNASSIGNED: We hypothesized that Anisakis larvae may have migrated outside the gastrointestinal tract, penetrating the diaphragm and settling in the pericardium, causing pericarditis and pericardial effusion. Clinicians should know that the pericardium may be another extra-abdominal localization of anisakiasis, beyond pleuro-pulmonary involvement.
UNASSIGNED: A 26-year-old man presented to the emergency department because of progressive lower limb oedema and exertional dyspnoea. Two months prior, he had consumed raw fish without any gastrointestinal symptoms. The echocardiogram reported a circumferential pericardial effusion (\'swinging heart\') and mildly reduced left ventricular ejection fraction (LVEF). He was diagnosed with myopericarditis after a cardiac magnetic resonance. A fluorodeoxyglucose positron emission tomography scan revealed an intense pericardial metabolism. Blood tests exhibited persistent eosinophilia and mild elevation of Anisakis simplex IgE-as for past infestation. A pericardial drainage was performed, subsequently, serial echocardiograms revealed a spontaneous recovery of his LVEF. No autoimmune, allergic, or onco-haematologic diseases were identified. Based on a history of feeding with potentially contaminated raw fish and on long-lasting eosinophilia, we suspected a pericardial anisakiasis, despite a low but persistent titre of specific IgE. Albendazole was administered for 21 days, along with colchicine and ibuprofen for 2 months; pericardial effusion resolution and eosinophil normalization occurred two weeks after.
UNASSIGNED: We hypothesized that Anisakis larvae may have migrated outside the gastrointestinal tract, penetrating the diaphragm and settling in the pericardium, causing pericarditis and pericardial effusion. Clinicians should know that the pericardium may be another extra-abdominal localization of anisakiasis, beyond pleuro-pulmonary involvement.
摘要：
■异尖鱼通过食用被污染的未煮熟或生鱼来感染人类，导致胃病，胃过敏性茴香病，或无症状污染。尽管幼虫通常在穿透胃组织时死亡，描述了腹内和腹外扩散的病例。我们报告了首例可能的心包anisakiasis病例。
■一名26岁的男子因进行性下肢水肿和劳力性呼吸困难出现在急诊科。两个月前,他食用生鱼，没有任何胃肠道症状。超声心动图报告环状心包积液（“心脏摆动”）和轻度降低的左心室射血分数（LVEF）。他在心脏磁共振检查后被诊断患有心肌心包炎。氟脱氧葡萄糖正电子发射断层扫描显示心包代谢强烈。血液检查显示持续的嗜酸性粒细胞增多和单纯异尖异象IgE的轻度升高-与过去的感染一样。进行心包引流,随后,连续超声心动图显示他的LVEF自发恢复。没有自身免疫,过敏,或癌血液病被确定。根据食用可能被污染的生鱼的历史和持续的嗜酸性粒细胞增多，我们怀疑是心包anisakiasis,尽管特异性IgE滴度低但持续存在。阿苯达唑给药21天，与秋水仙碱和布洛芬一起2个月;心包积液消退和嗜酸性粒细胞恢复正常两周后。
■我们假设异语幼虫可能已经迁移到胃肠道外，穿透隔膜并在心包中沉降，引起心包炎和心包积液.临床医生应该知道心包可能是另一种腹外定位的anisakiasis，除了胸膜肺受累。
■一名26岁的男子因进行性下肢水肿和劳力性呼吸困难出现在急诊科。两个月前,他食用生鱼，没有任何胃肠道症状。超声心动图报告环状心包积液（“心脏摆动”）和轻度降低的左心室射血分数（LVEF）。他在心脏磁共振检查后被诊断患有心肌心包炎。氟脱氧葡萄糖正电子发射断层扫描显示心包代谢强烈。血液检查显示持续的嗜酸性粒细胞增多和单纯异尖异象IgE的轻度升高-与过去的感染一样。进行心包引流,随后,连续超声心动图显示他的LVEF自发恢复。没有自身免疫,过敏,或癌血液病被确定。根据食用可能被污染的生鱼的历史和持续的嗜酸性粒细胞增多，我们怀疑是心包anisakiasis,尽管特异性IgE滴度低但持续存在。阿苯达唑给药21天，与秋水仙碱和布洛芬一起2个月;心包积液消退和嗜酸性粒细胞恢复正常两周后。
■我们假设异语幼虫可能已经迁移到胃肠道外，穿透隔膜并在心包中沉降，引起心包炎和心包积液.临床医生应该知道心包可能是另一种腹外定位的anisakiasis，除了胸膜肺受累。
