[Chronic hepatitis B with an unexpected coinfection].

Medizinische Klinik Pub Date : 2010-11-01 Epub Date: 2010-12-07 DOI:10.1007/s00063-010-1141-4
Thomas Göbel, Andreas Erhardt, Joachim Richter, Christopher Poremba, Dieter Häussinger
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引用次数: 1

Abstract

Background: Schistosomiasis and hepatitis B are both tropical diseases with more than 200 and 350 million people infected worldwide respectively, but are rare in western countries. Worldwide a high rate of coinfections can be expected.

Case report: A 34-year-old African patient was referred to our clinic with known hepatitis B/D-coinfection for evaluation of antiviral treatment.

Results: Surprisingly, liver biopsy showed a granuloma with the egg of Schistosoma in addition to virus induced alterations. Subsequent examination of the stool allowed to classify the parasite as Schistosoma mansoni. Thus, before initiation of an antiviral treatment, an antischistosomal therapy with praziquantel leading to elimination of schistosomiasis was started.

Conclusion: Patients from tropical countries suffering from chronic viral hepatitis may present with additional coinfections which can be earily overlooked in daily clinical routine. Screening of African patients from endemic areas for schistosomiasis should include examinations for tropical diseases by specialists.

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慢性乙型肝炎合并意外感染。
背景:血吸虫病和乙型肝炎都是热带疾病,全世界感染人数分别超过2亿人和3.5亿人,但在西方国家很少见。在世界范围内,可以预期合并感染率很高。病例报告:一名34岁的非洲患者被转介到我们的诊所,已知乙型/ d型肝炎合并感染,以评估抗病毒治疗。结果:令人惊讶的是,肝活检显示除了病毒引起的改变外,还有一个带有血吸虫卵的肉芽肿。随后的粪便检查允许将寄生虫分类为曼氏血吸虫。因此,在开始抗病毒治疗之前,开始使用吡喹酮进行抗血吸虫治疗,以消除血吸虫病。结论:热带国家的慢性病毒性肝炎患者可能出现其他合并感染,这在日常临床常规中可能被早期忽视。对来自流行地区的非洲患者进行血吸虫病筛查应包括由专家进行的热带病检查。
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Medizinische Klinik
Medizinische Klinik 医学-医学:内科
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[Liver--gallbladder]. [Iron deficiency]. [Frontotemporal dementia]. [Hepatic encephalopathy]. [ON CHILD ABUSE].
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