Department of Infectious Diseases, Faculty of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Acta Parasitol. 2023 Sep;68(3):711-717. doi: 10.1007/s11686-023-00705-x. Epub 2023 Aug 2.
This report presents a fatal case of disseminated strongyloidiasis in a patient with myasthenia gravis and diabetes mellitus who had received corticosteroid therapy.
The patient was a 67-year-old woman living in a rural area endemic for Strongyloides stercoralis in northern Iran. Disseminated strongyloidiasis was diagnosed in the advanced stage of the disease, with enormous numbers of larvae demonstrated in direct smears prepared from stool samples and stomach biopsy. Despite treatment with ivermectin and antibiotics, the patient succumbed to the severity of the infection.
Clinicians working in endemic areas should be mindful of the possibility of gastric involvement in strongyloidiasis, even if symptoms are nonspecific. We recommend that high-risk individuals be screened for S. stercoralis prior to immunosuppressive therapy in endemic regions to raise awareness and prevent similar cases.
本报告介绍了一例重症肌无力和糖尿病患者合并播散性粪类圆线虫病的致死病例,该患者曾接受皮质类固醇治疗。
患者为一名 67 岁女性,居住在伊朗北部农村地区,该地区为粪类圆线虫流行区。在疾病的晚期诊断出播散性粪类圆线虫病,直接从粪便样本和胃活检中发现了大量幼虫。尽管使用伊维菌素和抗生素进行治疗,但患者仍因感染严重而死亡。
在流行地区工作的临床医生应注意粪类圆线虫病可能累及胃部,即使症状不典型。我们建议在免疫抑制治疗前对流行地区的高危人群进行粪类圆线虫筛查,以提高认识并预防类似病例。