López-Delgado Darío Sebastián, Narváez Carlos A, Bonfante-Villalobos Roberto, Arteaga Joshua Emmanuel, Sanchez-Galvez Hector Fabio, Jurado Yamile, Rodriguez-Morales Alfonso J
Grupo Interdisciplinario de Investigación Salud Enfermedad (GIISE), Universidad Cooperativa de Colombia. San Juan de Pasto, Nariño, Colombia.
Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua.
Infez Med. 2025 Jun 1;33(2):233-238. doi: 10.53854/liim-3302-10. eCollection 2025.
(SS) is an intestinal parasite that can cause chronic asymptomatic infections, but in rare cases, it can progress to hyperinfection syndrome (SHS). This report describes a case of SHS associated with deep vein thrombosis and pulmonary thromboembolism, a rare manifestation in an immunocompetent patient. A 19-year-old female patient with a 15-day history of abdominal pain, progressive edema of the lower limbs, hemoptotic cough, asthenia, and weight loss. During her hospitalization, she developed sudden dyspnea, desaturation, and distributive shock, requiring invasive mechanical ventilation. Pulmonary angiotomography showed pulmonary thromboembolism, and deep vein thrombosis was diagnosed. Bronchoscopy revealed alveolar hemorrhage, while bronchoalveolar and duodenal lavage confirmed the presence of SS. Ivermectin and albendazole were started with full-dose anticoagulation for the thrombotic event. After one week of management, bronchoalveolar lavage results were negative, and the patient showed significant improvement with no long-term complications. SHS is rare in immunocompetent patients, and its association with thrombosis has been poorly documented in the literature. This case emphasizes the importance of early diagnosis and timely management to avoid life-threatening complications. It also highlights the need for surveillance in endemic regions and the appropriate use of evidence-based therapeutic strategies.
(粪类圆线虫)是一种肠道寄生虫,可引起慢性无症状感染,但在罕见情况下,可进展为重度感染综合征(SHS)。本报告描述了一例与深静脉血栓形成和肺血栓栓塞相关的重度感染综合征病例,这在免疫功能正常的患者中是一种罕见表现。一名19岁女性患者,有15天腹痛病史,下肢进行性水肿、咯血性咳嗽、乏力和体重减轻。住院期间,她突然出现呼吸困难、血氧饱和度下降和分布性休克,需要有创机械通气。肺血管造影显示肺血栓栓塞,并诊断为深静脉血栓形成。支气管镜检查显示肺泡出血,而支气管肺泡灌洗和十二指肠灌洗证实存在粪类圆线虫。开始使用伊维菌素和阿苯达唑,并对血栓形成事件进行全剂量抗凝治疗。经过一周的治疗,支气管肺泡灌洗结果为阴性,患者病情显著改善,无长期并发症。重度感染综合征在免疫功能正常的患者中罕见,其与血栓形成的关联在文献中记载较少。本病例强调了早期诊断和及时治疗以避免危及生命并发症的重要性。它还突出了在流行地区进行监测以及适当使用循证治疗策略的必要性。