与非流行国家的移民相比，旅行者中粪类圆线虫的临床表现及实验室检测的诊断敏感性

Clinical presentation and diagnostic sensitivity of laboratory tests for Strongyloides stercoralis in travellers compared with immigrants in a non-endemic country.

作者信息

Sudarshi Sonali, Stümpfle Richard, Armstrong Margaret, Ellman Thomas, Parton Simon, Krishnan Prabha, Chiodini Peter L, Whitty Christopher J M

机构信息

The Hospital for Tropical Diseases, London, UK.

出版信息

Trop Med Int Health. 2003 Aug;8(8):728-32. doi: 10.1046/j.1365-3156.2003.01069.x.

DOI:10.1046/j.1365-3156.2003.01069.x

PMID:12869094

Abstract

OBJECTIVES

To assess whether the clinical and laboratory methods for diagnosing Strongyloides stercoralis infection in non-endemic countries is different between those who are chronically exposed and those who travel.

METHODS

Analysis of laboratory and clinical data from 204 patients having S. stercoralis infection at the Hospital for Tropical Diseases, London.

RESULTS

Sixty-four travellers and 128 immigrants from endemic countries had laboratory-proven strongyloides. In those with microscopically proven disease, serology was 73% sensitive in travellers and 98% sensitive in immigrants (P < 0.001). There was no difference in the eosinophil count between the two groups with 19% having a normal count. Patterns of symptoms varied between the groups, and around one-third were asymptomatic in both groups. Serology was of limited use in follow-up.

CONCLUSIONS

Eosinophil count and stool microscopy are insufficiently sensitive to be used alone for screening strongyloides. The sensitivity of serology is good in immigrants with chronic infection, but lower in travellers.

摘要

目的

评估在非流行国家，长期暴露人群与旅行者中，用于诊断粪类圆线虫感染的临床和实验室方法是否存在差异。

方法

对伦敦热带病医院204例粪类圆线虫感染患者的实验室和临床数据进行分析。

结果

64名旅行者和128名来自流行国家的移民经实验室证实感染粪类圆线虫。在显微镜检查确诊的患者中，血清学检测在旅行者中的敏感性为73%，在移民中的敏感性为98%（P<0.001）。两组嗜酸性粒细胞计数无差异，19%的患者计数正常。两组症状模式不同，两组中约三分之一的患者无症状。血清学检测在随访中的作用有限。