Banjac Maja, Vujovic Ivana, Colovic Popadic Aleksandra, Devrnja Milica, Obradovic Dusanka S
Critical Care Department, Internal Medicine Department, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, SRB.
High Dependency Unit, Internal Medicine Department, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, SRB.
Cureus. 2025 Mar 14;17(3):e80557. doi: 10.7759/cureus.80557. eCollection 2025 Mar.
Strongyloidiasis is a widespread disease characterized clinically by acute or chronic manifestations, which, in high-risk individuals and immunocompromised individuals, can progress to hyperinfection syndrome and disseminated forms with significant mortality rates. Among extraintestinal organs, the lungs are most commonly affected. Clinical presentations are very diverse, contributing to the challenges of diagnosis and timely treatment initiation. We present the case of a 57-year-old patient who was admitted to the intensive care unit (ICU) due to bilateral pneumonia and septic shock. During a two-month hospitalization period, the patient spent 16 days on invasive mechanical ventilation. Initially, nonspecific symptoms, such as weakness, fatigue, and cough, evolved into complications, including diarrheal syndrome, hemoptysis, urticaria, and ventilator-associated pneumonia (VAP) caused by Gram-negative bacteria. Numerous larvae of were identified in a stool sample. In addition to antibiotic therapy, antiparasitic treatment was administered, resulting in significant improvement in the patient's overall condition, leading to discharge for further home care. In this case, community-acquired pneumonia was complicated by the reactivation of chronic strongyloidiasis in the form of hyperinfection syndrome in a high-risk patient. High-risk individuals and immunocompromised individuals should undergo screening for parasitic infections in cases presenting with gastrointestinal symptoms, particularly diarrhea and respiratory symptoms. Screening for parasitic infections should be integrated into routine clinical practice for this population.
类圆线虫病是一种广泛传播的疾病，临床上以急性或慢性表现为特征，在高危个体和免疫功能低下个体中，可进展为高度感染综合征和播散型，死亡率较高。在肠外器官中，肺部最常受累。临床表现非常多样，这给诊断和及时开始治疗带来了挑战。我们报告一例57岁患者，因双侧肺炎和感染性休克入住重症监护病房（ICU）。在为期两个月的住院期间，患者接受了16天的有创机械通气。最初，诸如虚弱、疲劳和咳嗽等非特异性症状逐渐发展为并发症，包括腹泻综合征、咯血、荨麻疹以及由革兰氏阴性菌引起的呼吸机相关性肺炎（VAP）。在一份粪便样本中发现了大量粪类圆线虫幼虫。除抗生素治疗外，还给予了抗寄生虫治疗，患者的整体状况有显著改善，随后出院接受进一步的家庭护理。在该病例中，社区获得性肺炎因高危患者慢性类圆线虫病以高度感染综合征形式重新激活而变得复杂。高危个体和免疫功能低下个体在出现胃肠道症状，尤其是腹泻和呼吸道症状时，应接受寄生虫感染筛查。对于这一人群，寄生虫感染筛查应纳入常规临床实践。
