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如何诊断和处理常见的寄生虫性肺炎。

How to diagnose and manage common parasitic pneumonias.

作者信息

Vijayan Vannan Kandi

机构信息

Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.

出版信息

Curr Opin Pulm Med. 2007 May;13(3):218-24. doi: 10.1097/MCP.0b013e3280f31b58.

Abstract

PURPOSE OF REVIEW

Parasitic pneumonia is being increasingly reported from many parts of the world due to globalization and travel across the continents. This review outlines the recent developments in the diagnosis and management of parasitic pneumonias.

RECENT FINDINGS

A polymerase chain reaction that can differentiate pathogenic Entamoeba histolytica from nonpathogenic species has been reported. It has been observed that pulmonary infection with Leishmania donovani can occur in immunodeficient and lung transplant patients. Acute respiratory distress syndrome, seen in severe falciparum malaria, has also been observed in vivax malaria. A study has demonstrated the return of chloroquine-sensitive falciparum malaria several years after chloroquine treatment was discontinued. Pulmonary hypertension has been reported in Schistosoma hematobium, S. mansoni and S. japonicum infections. Strongyloides hyperinfection and disseminated disease are frequently reported in immunocompromised individuals. Parenteral ivermectin is found to be useful in the treatment of disseminated strongyloidiasis. A chronic mild interstitial lung disease has been found to persist in tropical pulmonary eosinophilia despite treatment. Studies are in progress to develop vaccines against amoebiasis, malaria and hookworm infections.

SUMMARY

Parasitic pneumonia can sometimes be life threatening. If proper diagnosis is made early, the pneumonia can be treated successfully with currently available drugs.

摘要

综述目的

由于全球化以及跨大陆旅行,世界各地对寄生性肺炎的报道日益增多。本综述概述了寄生性肺炎诊断和管理方面的最新进展。

最新发现

已报道一种能区分致病性溶组织内阿米巴与非致病性物种的聚合酶链反应。据观察,杜氏利什曼原虫肺部感染可发生在免疫缺陷患者和肺移植患者中。在恶性疟原虫严重感染中出现的急性呼吸窘迫综合征,也在间日疟中被观察到。一项研究表明,氯喹治疗停止数年之后,对氯喹敏感的恶性疟原虫出现复发。在埃及血吸虫、曼氏血吸虫和日本血吸虫感染中,均有肺动脉高压的报道。免疫功能低下个体中频繁报道有类圆线虫超感染和播散性疾病。发现肠外伊维菌素对播散性类圆线虫病的治疗有用。尽管进行了治疗,但热带肺嗜酸性粒细胞增多症中仍存在一种慢性轻度间质性肺病。针对阿米巴病、疟疾和钩虫感染的疫苗研发正在进行中。

总结

寄生性肺炎有时可能危及生命。如果早期做出正确诊断,目前可用药物可成功治疗肺炎。

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