Goka A K, Rolston D D, Mathan V I, Farthing M J
Department of Gastroenterology, St Bartholomew's Hospital, West Smithfield, London, UK.
Trans R Soc Trop Med Hyg. 1990 Nov-Dec;84(6):829-31. doi: 10.1016/0035-9203(90)90098-y.
Faecal microscopical diagnosis of Strongyloides and hookworm infections is insensitive. We have therefore compared duodenal fluid and faecal microscopy for detection of these parasites in a group of 292 patients being investigated for gastrointestinal symptoms who were examined by both techniques. Thirty-three of these patients (8%) were infected with Strongyloides stercoralis and 88 (30%) had hookworm infections. Microscopical examination of up to 3 faecal specimens detected only 33% and 65% of patients with Strongyloides and hookworm infections, respectively. Microscopical examination of a single specimen of duodenal fluid was more sensitive for detection of strongyloidiasis, identifying 76% of patients; the parasite was found exclusively in duodenal fluid (and not in faeces) in 67% of patients. For hookworm, the diagnostic sensitivity was similar with both techniques but duodenal fluid microscopy detected some patients (35%) who had not been identified by faecal microscopy. This study confirms previous work indicating the insensitivity of faecal microscopy in these infections and emphasizes the need to consider routine examination of duodenal fluid to exclude chronic strongyloidiasis. This may have particular relevance for south-east Asian war veterans and immunocompromised patients.
粪类圆线虫和钩虫感染的粪便显微镜诊断并不敏感。因此，我们比较了十二指肠液和粪便显微镜检查在一组292例因胃肠道症状接受检查的患者中检测这些寄生虫的情况，这组患者同时接受了这两种检查技术。这些患者中有33例（8%）感染了粪类圆线虫，88例（30%）感染了钩虫。对多达3份粪便标本进行显微镜检查，分别仅检测出33%的粪类圆线虫感染患者和65%的钩虫感染患者。对一份十二指肠液标本进行显微镜检查对粪类圆线虫病的检测更敏感，可识别出76%的患者；67%的患者仅在十二指肠液中（而非粪便中）发现该寄生虫。对于钩虫，两种技术的诊断敏感性相似，但十二指肠液显微镜检查检测出了一些粪便显微镜检查未识别出的患者（35%）。这项研究证实了先前的研究结果，即粪便显微镜检查在这些感染中不敏感，并强调需要考虑常规检查十二指肠液以排除慢性粪类圆线虫病。这对于东南亚退伍军人和免疫功能低下的患者可能尤为重要。
