Link K, Orenstein R
Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Department of Medicine, Virginia Commonwealth University, Medical College of Virginia, Richmond, USA.
South Med J. 1999 Jul;92(7):728-31. doi: 10.1097/00007611-199907000-00016.
We report the case of a 64-year-old veteran who had Streptococcus bovis meningitis as a result of a long latent Strongyloides infection that became acute when he was treated with prednisone. We reviewed 38 reported cases of serious bacterial infections associated with strongyloidiasis. Patients most frequently had nonspecific gastrointestinal symptoms. Of these 38 patients, 21 (55%) had meningitis, and 28 (73%) had bacteremia that was polymicrobial in 3 cases (8%). Other sites of infection included lung, bone marrow, ascites, mitral valve, and lymph node. Most infections were due to enteric gram-negative bacteria. There is one previously reported case of S bovis meningitis. Thirty-four of the patients (89%) were immunosuppressed; 21 of these (55%) were taking pharmacologic doses of adrenal corticosteroids. Thirty-three of the 38 (87%) patients died. Patients with enteric bacterial infection without an obvious cause should be tested for the presence of strongyloidiasis.
我们报告了一例64岁退伍军人的病例，该患者因长期潜伏的类圆线虫感染而患上牛链球菌脑膜炎，在接受泼尼松治疗时病情急性发作。我们回顾了38例报告的与类圆线虫病相关的严重细菌感染病例。患者最常出现非特异性胃肠道症状。在这38例患者中，21例（55%）患有脑膜炎，28例（73%）患有菌血症，其中3例（8%）为多种微生物感染。其他感染部位包括肺、骨髓、腹水、二尖瓣和淋巴结。大多数感染是由肠道革兰氏阴性菌引起的。此前有一例牛链球菌脑膜炎的报告病例。34例患者（89%）存在免疫抑制；其中21例（55%）正在服用药理剂量的肾上腺皮质类固醇。38例患者中有33例（87%）死亡。对于无明显病因的肠道细菌感染患者，应检测是否存在类圆线虫病。
