一名免疫功能低下患者的致命性类圆线虫超感染综合征
Fatal Strongyloides Hyperinfection Syndrome in an Immunocompromised Patient.
作者信息
Pochineni Vaishnavi, Lal Darshan, Hasnayen Shahed, Restrepo Erfidia
机构信息
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, USA.
出版信息
Am J Case Rep. 2015 Sep 8;16:603-5. doi: 10.12659/AJCR.894110.
BACKGROUND
Currently, it is normal to screen for Strongyloides as part of the workup in pre-transplant patients who have eosinophilia. Given the high mortality rates in Strongyloides hyperinfection, this article illustrates the need to screen all patients with eosinophilia who will be started on immunosuppression.
CASE REPORT
We present here an interesting case of a 76-year-old man with membranous glomerulopathy who developed a severe Strongyloides hyperinfection that required an ICU stay and ultimately led to his death a few weeks after initiation of cyclophosphamide and steroids.
CONCLUSIONS
We recommend that a detailed workup to detect or rule out this parasitic infection be conducted prior to the initiation of immunosuppression in any patient with eosinophilia.
背景
目前，在对有嗜酸性粒细胞增多的移植前患者进行检查时，将类圆线虫筛查作为其中一部分是常规操作。鉴于类圆线虫高度感染的高死亡率，本文阐述了对所有将开始免疫抑制治疗的嗜酸性粒细胞增多患者进行筛查的必要性。
病例报告
我们在此呈现一例有趣的病例，一名76岁患有膜性肾小球病的男性发生了严重的类圆线虫高度感染，需要入住重症监护病房，最终在开始使用环磷酰胺和类固醇治疗几周后死亡。
结论
我们建议，在对任何嗜酸性粒细胞增多的患者开始免疫抑制治疗之前，应进行详细检查以检测或排除这种寄生虫感染。
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