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一名肠道移植受者感染粪类圆线虫

Strongyloides stercoralis infection in an intestinal transplant recipient.

作者信息

Hsu C N, Tseng S H, Chang S W, Chen Y

机构信息

Division of Pediatric Surgery, Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei, Taiwan.

出版信息

Transpl Infect Dis. 2013 Aug;15(4):E139-43. doi: 10.1111/tid.12104. Epub 2013 Jun 23.

Abstract

Strongyloides stercoralis is a helminth in tropical and subtropical areas. It may cause latent infection and progress to Strongyloides hyperinfection syndrome, which is associated with a high mortality rate. Transplant recipients under the treatment of immunosuppressant agents are at risk of severe S. stercoralis infection. According to related literature, most cases of S. stercoralis infection after solid organ transplantation are caused by reactivation of latent infections in the recipients, whereas only a few are acquired from the donors. We report on an intestinal transplant recipient who had S. stercoralis infection diagnosed by a larva of this parasite found in the stool from the ileostomy stoma 1 month after transplantation. The donor was considered the source of the infection because the donor was from an endemic area and had marked eosinophilia, and the recipient had no contact history or clinical manifestations related to the S. stercoralis infection before transplantation. The patient was treated with ivermectin and exhibited no evidence of infection after 7 months.

摘要

粪类圆线虫是热带和亚热带地区的一种蠕虫。它可能导致潜伏感染,并进展为粪类圆线虫超感染综合征,该综合征与高死亡率相关。接受免疫抑制剂治疗的移植受者有发生严重粪类圆线虫感染的风险。根据相关文献,实体器官移植后大多数粪类圆线虫感染病例是由受者潜伏感染的重新激活引起的,而只有少数是从供者获得的。我们报告了一名肠道移植受者,在移植后1个月,通过回肠造口术粪便中发现的这种寄生虫幼虫确诊为粪类圆线虫感染。供者被认为是感染源,因为供者来自流行地区且有明显嗜酸性粒细胞增多,而受者在移植前没有与粪类圆线虫感染相关的接触史或临床表现。患者接受了伊维菌素治疗,7个月后未出现感染迹象。

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