Gastroenterology, Naha City Hospital, Japan.
Respiratory Diseases, Naha City Hospital.
Rev Esp Enferm Dig. 2024 Oct;116(10):574-575. doi: 10.17235/reed.2024.10292/2024.
A 91-year-old man was admitted with vomiting and abdominal pain. He had had COVID-19 pneumonia a month before and the treatment had consisted of remdesivir, dexamethasone and baricitinib. CT scans showed pneumatosis intestinalis. His respiratory condition rapidly deteriorated and chest CT scans showed ground-glass opacity and Strongyloides stercoralis was identified in the sputum, making a diagnosis of hyperinfection syndrome associated acute respiratory distress syndrome. Treatment of ivermectin was not achieved in time and he died of multiple organ failure. S. stercoralis is a soil-transmitted helminth endemic to tropical and subtropical areas. Immunosuppressive conditions can cause hyperinfection syndrome and life-threatening conditions. Our case highlights the importance of assessing for untreated chronic strongyloidiasis in COVID-19 patients requiring steroid treatment in endemic areas.
一位 91 岁男性因呕吐和腹痛入院。他在一个月前患有 COVID-19 肺炎，治疗包括瑞德西韦、地塞米松和巴瑞替尼。CT 扫描显示肠气肿。他的呼吸状况迅速恶化，胸部 CT 扫描显示磨玻璃影，痰液中发现 Strongyloides stercoralis，诊断为与过度感染综合征相关的急性呼吸窘迫综合征。伊维菌素治疗未能及时进行，他因多器官衰竭而死亡。S. stercoralis 是一种流行于热带和亚热带地区的土壤传播的蠕虫。免疫抑制状态可导致过度感染综合征和危及生命的情况。我们的病例强调了在流行地区需要类固醇治疗的 COVID-19 患者中，评估未经治疗的慢性 Strongyloides stercoralis 的重要性。
