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肺血栓栓塞症——免疫功能正常患者中类圆线虫超感染的罕见表现。

Pulmonary thromboembolism-a rare presentation for Strongyloides hyperinfection in an immunocompetent patient.

作者信息

Ali Mir Wasim, Rakshit Soumadip, Sarkar Atreyee, Mondal Md Karimulla, Datta Anup Kumar, Chatterjee Uttara

机构信息

Department of Internal Medicine, IPGMER & SSKM Hospital, 242 Harish Mukherjee Road, Kolkata 700020, India.

Department of Pathology, IPGMER & SSKM Hospital, 242 Harish Mukherjee Road, Kolkata 700020, India.

出版信息

Oxf Med Case Reports. 2024 Dec 10;2024(12):omae152. doi: 10.1093/omcr/omae152. eCollection 2024 Dec.

Abstract

is an intestinal nematode. It is widely distributed in the tropics and sub-tropics of the world. It can cause a wide array of illnesses ranging from asymptomatic autoinfection to a severe form of hyperinfection and disseminated strongyloidiasis. Here we report a case of a 73-year-old patient presenting with obstructive shock with bipedal edema without any evidence of adrenal insufficiency. An upper gastrointestinal endoscopy revealed larva in the lumen of duodenal crypts. Stool examination and broncho-alveolar lavage revealed the presence of S. stercoralis larva. Computed tomography of pulmonary angiography revealed pulmonary thromboembolism. A long segment thrombus was also noted in the right external iliac vein on color Doppler with negative screening for malignancy on computed tomography scan. This case suggests that pulmonary thromboembolism with anemia and hypoalbuminemia could be a rare presentation of a systemic illness like Strongyloides hyperinfection in an immunocompetent patient from the tropics.

摘要

是一种肠道线虫。它广泛分布于世界热带和亚热带地区。它可导致一系列疾病,从无症状的自身感染到严重的超感染和播散性类圆线虫病。在此,我们报告一例73岁患者,表现为梗阻性休克伴双下肢水肿,且无任何肾上腺功能不全的证据。上消化道内镜检查显示十二指肠隐窝腔内有幼虫。粪便检查和支气管肺泡灌洗显示存在粪类圆线虫幼虫。肺血管造影计算机断层扫描显示肺血栓栓塞。彩色多普勒检查还发现右髂外静脉有一段长血栓,计算机断层扫描恶性肿瘤筛查为阴性。该病例提示,在来自热带地区的免疫功能正常患者中,伴有贫血和低白蛋白血症的肺血栓栓塞可能是类圆线虫超感染等全身性疾病的一种罕见表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a4c/11631262/dc4cbd4bef15/omae152f1.jpg

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