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The Korean Journal of Medicine 2008;74(4): 451-456.
증례 : 폐흡충증과 연관된 급성 호산구성 전격성 심근염 1예
문한국, 박대균, 김성은, 윤덕형, 이준희, 한규록, 오동진
A case of acute eosinophilic fulminant myocarditis associated with paragonimiasis
Han-Kook Moon, Dae-Gyun Park, Sung-Eun Kim, Duk-Hyung Yoon, Jun-Hee Lee, Kyoo-Rok Han, Dong-Jin Oh
경희대학교 의과대학 순환기내과학교실
ABSTRACT
Fulminant myocarditis is characterized by critical illness at presentation. However, if affected patients recover with pharmacologic therapy and mechanical circulatory support, they may have a better long-term prognosis than patients with other forms of myocarditis. A 31-year-old man was admitted due to chest pain associated with dyspnea. Electrocardiogram showed ST-segment elevation in all leads except for aVR and aVL. Non-sustained ventricular tachycardia developed 12 hours after admission. The echocardiography showed diffuse hypokinesia, concentric edematous thickening of the left ventricular wall, and pericardial effusion. Serum cardiac enzymes and absolute eosinophil count were elevated. Since the ELISA (Enzyme-Linked Immunosorbent Assay) against Paragonimus westermani was positive, the patient was treated with praziquantel for 2 days. Eosinophil count normalized after 10 days, with conversion to negativity on ELISA after 4 weeks. We concluded that his myocarditis was probably caused by allergic reaction secondary to Paragonimus westermani infection.
Keywords: Myocarditis; Eosinophilia; Paragonimiasis
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