Orlent H, Crawley C, Cwynarski K, Dina R, Apperley J
Department of Haematology, Academisch Ziekenhuis Rotterdam, Dijkzigt, The Netherlands.
Bone Marrow Transplant. 2003 Jul;32(1):115-7. doi: 10.1038/sj.bmt.1704104.
Hyperinfection with strongyloides stercolis occurs in the setting of chronic strongyloides infection in conjunction with immune suppression. Although malnutrition remains the major secondary cause worldwide in the developed world, iatrogenic immune suppression is an important precipitant. Autologous stem cell transplantation recipients are significantly immunocompromised albeit temporarily. Despite the increasing use of haemopoetic stem cell transplantation, hyperinfection with strongyloides has rarely been reported. We describe two cases of patients transplanted with chronic strongyloidiasis. In one case eradication therapy was given prior to the transplant which was uncomplicated. In the second case strongyloidiasis was diagnosed post transplant which was complicated by infection and respiratory compromise. Fatal hyperinfection subsequently developed after corticosteroid therapy was started for a disease progression in the CNS.
粪类圆线虫高度感染发生于慢性粪类圆线虫感染合并免疫抑制的情况下。在发达国家，尽管营养不良仍是全球主要的次要病因，但医源性免疫抑制是一个重要的促发因素。自体干细胞移植受者虽只是暂时严重免疫功能低下。尽管造血干细胞移植的应用日益增多，但粪类圆线虫高度感染却鲜有报道。我们描述了两例患有慢性粪类圆线虫病的移植患者。其中一例在移植前进行了根除治疗，过程顺利。另一例在移植后诊断出粪类圆线虫病，并发感染和呼吸功能不全。随后，因中枢神经系统疾病进展开始使用皮质类固醇治疗后，发生了致命的高度感染。
