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免疫功能低下患者的严重腹泻和体重减轻。

Profound diarrhoea and weight loss in an immunocompromised patient.

机构信息

Gastroenterology Unit, NHS Lothian, Edinburgh, UK

Gastroenterology Unit, NHS Lothian, Edinburgh, UK.

出版信息

BMJ Case Rep. 2021 Jan 18;14(1):e236913. doi: 10.1136/bcr-2020-236913.

Abstract

A 75-year-old man was admitted with a 3-month history of worsening diarrhoea and weight loss. He was on long-term immunosuppression following cardiac transplantation. Investigations revealed herpes simplex oesophagitis and stool samples were positive for norovirus. Treatment with acyclovir and nitazoxanide resulted in a complete resolution of symptoms. Norovirus is a common cause of infectious gastroenteritis, but immunosuppressed patients may present with chronic diarrhoea rather than an acute illness. This case highlights the importance of a low clinical threshold for testing for norovirus infection in immunocompromised patients.

摘要

一位 75 岁男性因腹泻和体重减轻加重 3 个月而入院。他在心脏移植后长期接受免疫抑制治疗。检查发现单纯疱疹性食管炎,粪便样本检测出诺如病毒阳性。阿昔洛韦和硝唑尼特治疗后症状完全缓解。诺如病毒是感染性胃肠炎的常见病因,但免疫抑制患者可能表现为慢性腹泻而不是急性疾病。本病例强调了对免疫功能低下患者进行诺如病毒感染检测的临床阈值低的重要性。

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本文引用的文献

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Recurring & Infection in a Renal Transplant Patient.肾移植患者的反复感染
IDCases. 2020 Apr 23;20:e00776. doi: 10.1016/j.idcr.2020.e00776. eCollection 2020.
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Chronic norovirus infection and common variable immunodeficiency.慢性诺如病毒感染与常见变异型免疫缺陷
Clin Exp Immunol. 2017 Jun;188(3):363-370. doi: 10.1111/cei.12884. Epub 2016 Nov 16.
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Norovirus.诺如病毒
Clin Microbiol Rev. 2015 Jan;28(1):134-64. doi: 10.1128/CMR.00075-14.
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Norovirus gastroenteritis.诺如病毒肠胃炎
N Engl J Med. 2009 Oct 29;361(18):1776-85. doi: 10.1056/NEJMra0804575.

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