Kinjo Takeshi, Nabeya Daijiro, Nakamura Hideta, Haranaga Shusaku, Hirata Tetsuo, Nakamoto Tomoko, Atsumi Eriko, Fuchigami Tatsuya, Aoki Yoichi, Fujita Jiro
Department of Infectious Diseases, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Japan.
Intern Med. 2015;54(1):83-7. doi: 10.2169/internalmedicine.54.3284. Epub 2015 Jan 1.
A 62-year-old woman complained of diarrhea and vomiting after receiving chemotherapy for cervical cancer in association with high doses of corticosteroids. Two months later, the patient developed acute respiratory distress syndrome, and numerous Strongyloides stercoralis parasites were found in the intrabronchial discharge. Ivermectin was administered daily until nematodes were no longer detected in the sputum, and the patient's condition was successfully rescued. Antibodies for human T-cell lymphotropic virus-1 (HTLV-1) were positive. HTLV-1 infection and the administration of corticosteroids are known risk factors for strongyloides hyperinfection syndrome. Therefore, physicians should consider this disease in the differential diagnosis of patients from endemic areas who present with gastrointestinal symptoms under these risk factors.
一名62岁女性在接受宫颈癌化疗并联用大剂量皮质类固醇后出现腹泻和呕吐。两个月后，该患者发生急性呼吸窘迫综合征，支气管分泌物中发现大量粪类圆线虫寄生虫。每天给予伊维菌素，直至痰液中未再检测到线虫，患者病情成功获救。人类嗜T淋巴细胞病毒1型（HTLV-1）抗体呈阳性。HTLV-1感染和皮质类固醇的使用是类圆线虫超感染综合征的已知危险因素。因此，医生在对这些危险因素下出现胃肠道症状的流行地区患者进行鉴别诊断时应考虑此病。
