Wang Li-Fu, Xu Lian, Luo Shi-Qi, Xie Hui, Chen Wei, Wu Zhong-Dao, Sun Xi
Department of Parasitology of Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080, China.
Parasitol Res. 2017 Apr;116(4):1159-1163. doi: 10.1007/s00436-017-5389-y. Epub 2017 Jan 26.
Strongyloidiasis is one of the neglected tropical diseases caused by infection with the nematode Strongyloides genus and distributed worldwide. Strongyloidiasis can be fatal in immunosuppressed patients induced hyperinfection or disseminated strongyloidiasis. Unfortunately, until now, due to the unspecific clinical symptom in infected individuals and the low sensitivity diagnosis of strongyloidiasis, many patients were misdiagnosed every year. Furthermore, the larvae of the Strongyloides stercoralis (S. stercoralis) is similar to other nematodes such as hookworm, Trichostrongylus increased the difficulty of diagnosis. In this case, the patient is a 63-year-old male person, who had a nearly 30 years medical history of asthma and emphysema, and 4-5-year medical history of diabetes. The sputum examination found some parasite larvae, then we identify the larvae using clinical observation and morphological characteristics combine with examined cytochrome oxidase subunit 1 (COX1) and 18S rRNA genes by PCR, sequence analysis and finally classified by phylogenetic analysis, the larvae were diagnosed as S. stercoralis. Our results showed that diagnosis with strongyloidiasis by morphological characteristics combine with molecular biological methods can improve the sensitive of diagnosis and provide a final diagnosis for the disease in the clinics.
类圆线虫病是由线虫类圆线虫属感染引起的被忽视的热带疾病之一,在全球范围内均有分布。类圆线虫病在免疫抑制患者中可引发高度感染或播散性类圆线虫病,进而导致死亡。遗憾的是,直至如今,由于受感染个体临床症状不具特异性以及类圆线虫病诊断敏感性较低,每年都有许多患者被误诊。此外,粪类圆线虫的幼虫与其他线虫如钩虫、毛圆线虫相似,这增加了诊断的难度。在此病例中,患者为一名63岁男性,有近30年哮喘和肺气肿病史,以及4至5年糖尿病病史。痰液检查发现了一些寄生虫幼虫,随后我们通过临床观察和形态特征,结合PCR检测细胞色素氧化酶亚基1(COX1)和18S rRNA基因、序列分析,并最终通过系统发育分析进行分类,将这些幼虫诊断为粪类圆线虫。我们的结果表明,通过形态特征与分子生物学方法相结合诊断类圆线虫病,可提高诊断的敏感性,并为临床疾病提供最终诊断。