美国女子用自来水冲洗鼻腔 感染食脑虫死亡
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■电脑断层扫描显示,脑部感染阿米巴虫的变化。asm.org图片
华盛顿州西雅图一名女子怀疑以自来水冲洗鼻窦后,导致脑部感染阿米巴虫(Balamuthia
mandrillaris)死亡。医生指,病人感染后一年,身体各处出现不同症状,可惜太迟发现病因,最终返魂乏术。
综合CNN及CBS报道,最新一期《国际传染病杂志》刊出这宗罕见病例,69岁死者因受鼻窦炎困扰,于是用洗鼻壶灌洗鼻腔,借此冲洗致敏原及黏液以改善病情,不料先是鼻梁出现红疮,后来左边身体开始颤抖、手臂乏力。
去年初,这名病人因癫痫发作送院,电脑断层扫描显示其脑部有肿瘤,医生为她切除硬币大小的肿块之后,病人情况急转直下,病变迅速扩散,两星期后医生再次做手术,由脑部取出棒球大小的肿瘤。医生检查组织后,始发现是阿米巴虫作怪,通知疾病控制和预防中心(CDC)索取抗虫药物米替福(miltefosine),当时病人已陷入昏迷,最终不治。主诊医生科布斯(Charles
Cobbs)认为,病人感染阿米巴虫可能是不当使用洗鼻壶所致。死者生前曾透露,没有依指示使用盐水或开水灌洗鼻腔,而是直接使用过滤的自来水。
科布斯指,不排除自来水是感染源头,但这种情况非常罕见。阿米巴虫最早于1986年被发现,变形虫经鼻腔进入脑部后会蚕食大脑组织。CDC表示,1993年至今全美有至少70宗病例,死亡率超过89%,病人往往病入膏肓甚至死亡后才找到原因,因此医学界对此病所知甚少。以这次病人为例,虽然病发前鼻上出现红疮,皮肤科医生一直认为是皮疹,科布斯希望,此事能让其他医生提高警觉。
CDC强调,饮用自来水不会感染阿米巴虫,只要市民使用洗鼻壶前遵循指示,只使用盐水、煮沸的水或蒸馏水,并且清洗、风干设备便能有效预防。
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