人芽囊原蟲感染肝臟囊腫之案例報告
 
張益華¹　葉俊濬¹　陳啟益²

 
人芽囊原蟲(Blastocystis hominis)是常見於人類胃腸道的單細胞寄生蟲。它的致病性仍未知。一位78歲女性，為腎臟癌合併肺部轉移，抱怨右上腹疼痛。腹部超音波及電腦斷層顯示肝臟右葉一個巨大囊腫，囊液檢測顯示許多人芽囊原蟲。之後接受首次metronidazole 14天療程。一年後，因囊腫引流導致囊內出血及橫膈下腔血腫，接受手術切除肝臟囊腫。囊液檢測再次顯示許多人芽囊原蟲。在metronidazole 20天療程後的45天糞便檢查呈現陰性。據我們所知，這是第一個肝臟囊腫感染人芽囊原蟲的案例報告。對於此受感染肝臟囊腫足夠抗生素療程的確認及其引流或切除的必要性，仍待未來進一步的研究探討。
（台灣家醫誌2022; 32: 66-70）DOI: 10.53106/168232812022033201007
 
關鍵詞：人芽囊原蟲、肝臟囊腫、寄生蟲
 

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¹戴德森醫療財團法人嘉義基督教醫院家庭醫學科、²戴德森醫療財團法人嘉義基督教醫院內科部胃腸肝膽科
受理日期：110年3月26日　修改日期：110年4月25日　　同意刊登：110年5月5日
通訊作者：陳啟益　　　　通訊地址：嘉義市忠孝路539號　E-mail: 5137ccy@gmail.com

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Blastocystis Species in Liver Cysts: A Case Report
 
Yi-Hua Chang¹, Jun-Jun Yeh¹ and Chi-Yi Chen²

 
Blastocystis hominis is a unicellular parasitic microorganism commonly found in the gastrointestinal tracts of humans. Its pathogenicity remains uncertain. A 78-year-old female patient with renal cell carcinoma and lung metastasis complained of right upper quadrant pain. Abdominal ultrasonography and computed tomography scan showed a huge liver cyst in which a plethora of Blastocystis hominis was identified through cyst fluid analysis. The patient then received her first course of metronidazole treatment for 14 days. One year later, she underwent resection of the liver cyst due to internal bleeding and subphrenic hematoma induced by cyst drainage procedure. Cyst fluid analysis again revealed a profusion of Blastocystis hominis. Stool examination showed a negative result 45 days after a course of metronidazole for 20 days. To the best of our knowledge, this is the first case of the presence of Blastocystis hominis in liver cyst. However, further studies are required to determine the adequate course of antibiotic treatment and necessity of drainage or resection of the infected liver cyst.
(Taiwan J Fam Med 2022; 32: 66-70) DOI: 10.53106/168232812022033201007
 
Key words: Blastocystis hominis, blastocystis species, liver cyst, parasite
 

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¹Division of Family Medicine, ²Division of Gastroenterology and Hepatology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.
Received: March 26, 2021; Revised: April 25, 2021; Accepted: May 5, 2021.