Ben-Horin Shomron, Barshack Iris, Chowers Yehuda, Mouallem Meir
Gastroenterology Department, Sheba Medical Center, Tel-Hashomer 52621, Israel.
World J Gastroenterol. 2008 Jul 21;14(27):4413-5. doi: 10.3748/wjg.14.4413.
Super-imposed infection with intestinal organisms can mimic a flare-up of underlying disease in patients with inflammatory bowel disease (IBD). We report a case of patient with long standing ulcerative colitis (UC), who presented with abdominal pain, diarrhea and low-grade fever after receiving systemic corticosteroids for an unrelated disorder. Despite a negative stool examination, a peripheral eosinophilia reappeared upon tapering down of a corticosteroid dose. Subsequently, duodenal biopsies showed evidence for Strongyloides, presumably acquired 20 years ago when the patient was residing in Brazil. The patient fully recovered following anti-helmintic therapy. This case underscores the importance of considering Strongyloides in the work-up of flaring-up IBD patients, even if a history of residing or traveling to endemic areas is in the distant past.
肠道微生物的叠加感染可模拟炎症性肠病（IBD）患者潜在疾病的发作。我们报告一例长期溃疡性结肠炎（UC）患者，该患者因 unrelated disorder 接受全身皮质类固醇治疗后出现腹痛、腹泻和低热。尽管粪便检查结果为阴性，但在皮质类固醇剂量逐渐减小时外周嗜酸性粒细胞增多再次出现。随后，十二指肠活检显示有类圆线虫感染的证据，推测是患者 20 年前居住在巴西时感染的。患者在接受抗蠕虫治疗后完全康复。该病例强调了在 IBD 发作患者的检查中考虑类圆线虫感染的重要性，即使患者居住或前往流行地区的历史已经是很久以前的事了。 （注：原文中“unrelated disorder”不太明确具体所指，翻译时保留原文表述）
