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一例尿沉渣中发现虫体而诊断的播散性粪类圆线虫病。

A case of disseminated strongyloidiasis diagnosed by worms in the urinary sediment.

机构信息

Department of Infection Biology and Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea.

出版信息

Parasites Hosts Dis. 2024 May;62(2):238-242. doi: 10.3347/PHD.23124. Epub 2024 May 27.

Abstract

Strongyloidiasis is a chronic infection caused by the intestinal nematode parasite Strongyloides stercoralis and is characterized by a diverse spectrum of nonspecific clinical manifestations. This report describe a case of disseminated strongyloidiasis with urination difficulty, generalized weakness, and chronic alcoholism diagnosed through the presence of worms in the urinary sediment. A 53-year-old man was hospitalized for severe abdominal distension and urinary difficulties that started 7-10 days prior. The patient also presented with generalized weakness that had persisted for 3 years, passed loose stools without diarrhea, and complained of dyspnea. In the emergency room, approximately 7 L of urine was collected, in which several free-living female adult and rhabditiform larvae of S. stercoralis, identified through their morphological characteristics and size measurements, were detected via microscopic examination. Rhabditiform larvae of S. stercoralis were also found in the patient's stool. During hospitalization, the patient received treatment for strongyloidiasis, chronic alcoholism, peripheral neurosis, neurogenic bladder, and megaloblastic anemia, and was subsequently discharged with improved generalized conditions. Overall, this report presents a rare case of disseminated strongyloidiasis in which worms were detected in the urinary sediment of a patient with urination difficulties and generalized weakness combined with chronic alcoholism, neurogenic bladder, and megaloblastic anemia.

摘要

粪类圆线虫病是一种由肠道线虫寄生虫粪类圆线虫引起的慢性感染,其特征是具有广泛的非特异性临床表现。本报告描述了一例通过尿沉渣中发现的蠕虫诊断为伴有排尿困难、全身乏力和慢性酒精中毒的播散性粪类圆线虫病的病例。一名 53 岁男性因严重腹胀和排尿困难入院,这些症状始于 7-10 天前。患者还出现全身乏力,已持续 3 年,排不成形便但无腹泻,并主诉呼吸困难。在急诊室,收集了约 7 L 的尿液,通过显微镜检查发现其中存在数条自由生活的雌性成虫和粪类圆线虫的杆状幼虫,根据其形态特征和大小测量进行了鉴定。患者的粪便中也发现了粪类圆线虫的杆状幼虫。住院期间,患者接受了针对粪类圆线虫病、慢性酒精中毒、周围神经病、神经性膀胱和巨幼细胞性贫血的治疗,随后病情好转出院。总的来说,本报告介绍了一例罕见的播散性粪类圆线虫病病例,该病例中,一名伴有排尿困难和全身乏力的患者的尿沉渣中检测到了蠕虫,同时还合并有慢性酒精中毒、神经性膀胱和巨幼细胞性贫血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5838/11150928/70d22a645821/phd-23124f1.jpg

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