Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires.
Am J Trop Med Hyg. 2010 Jun;82(6):1088-93. doi: 10.4269/ajtmh.2010.09-0332.
Strongyloides stercoralis chronic infections are usually asymptomatic and underestimated. We used direct fresh stool examination, Ritchie's method, and agar plate culture for diagnosis in patients with eosinophilia and previous residence in endemic areas. The frequency of strongyloidosis detected among these patients was high: 21 of 42 were positive. Among them, 10 were positive only by agar plate culture. After ivermectin treatment, patients resulted negative for parasitological tests and reduced their eosinophil counts. Half of the submitted patients that were followed 4-12 months after treatment remained negative without eosinophilia, except one who showed an eosinophil ascending curve before reappearance of larvae in stools. The high frequency of strongyloidosis found in this group emphasizes the relevance of including this parasitosis among differential diagnosis in patients with eosinophilia and past risk of S. stercoralis infection to prevent disseminated infections secondary to corticoid therapy.
粪直接镜检、Ritchie 法和琼脂平板培养用于诊断嗜酸性粒细胞增多症和曾居住在流行地区的患者。在这些患者中,检测到的旋毛虫病频率很高:42 例中有 21 例阳性。其中,10 例仅通过琼脂平板培养阳性。伊维菌素治疗后,患者寄生虫学检查转为阴性,嗜酸性粒细胞计数降低。在治疗后 4-12 个月进行随访的一半患者中,除 1 例在粪便中再次出现幼虫前嗜酸性粒细胞呈上升曲线外,均保持阴性且无嗜酸性粒细胞增多症。该组旋毛虫病的高频率强调了在嗜酸性粒细胞增多症和过去有 S. stercoralis 感染风险的患者中纳入这种寄生虫病的鉴别诊断的相关性,以预防因皮质类固醇治疗而继发的播散性感染。