Meltzer R S, Singer C, Armstrong D, Mayer K, Knapper W H
Am J Med Sci. 1979 Jan-Feb;277(1):91-8. doi: 10.1097/00000441-197901000-00012.
Strongyloidiasis is usually a benign illness confined to the gastrointestinal tract. However, dissemination (hyperinfection syndrome) may occur, particularly in patients with impaired cell-mediated immunity. The diagnosis of hyperinfection syndrome is often made postmortem, and mortality is high, even when the disease is recognized during life. Central nervous system involvement with Strongyloides stercoralis has previously been recognized in only a few cases at postmortem examination, and in one case antemortem. We describe a patient with disseminated strongyloidiasis in whom central nervous system involvement was diagnosed antemortem. This patient developed multiple bacterial and fungal systemic and central nervous system infections as a complication of disseminated strongyloidiasis. The natural history of the disease in man, factors predisposing to dissemination, immunologic aspects of helminthic infection, and treatment modalities are discussed.
粪类圆线虫病通常是一种局限于胃肠道的良性疾病。然而，播散（高度感染综合征）可能会发生，尤其是在细胞介导免疫受损的患者中。高度感染综合征的诊断通常在尸检时做出，即使在生前确诊，死亡率也很高。以前，仅在少数尸检病例以及1例生前病例中发现过粪类圆线虫累及中枢神经系统。我们描述了1例生前诊断为中枢神经系统受累的播散性粪类圆线虫病患者。该患者因播散性粪类圆线虫病并发多种细菌和真菌性全身及中枢神经系统感染。本文讨论了该疾病在人类中的自然病程、播散的易感因素、蠕虫感染的免疫学方面以及治疗方式。
