Wehner J H, Kirsch C M, Kagawa F T, Jensen W A, Campagna A C, Wilson M
Santa Clara Valley Medical Center, Division of Respiratory and Critical Care Medicine, San Jose, Calif 95128.
Chest. 1994 Sep;106(3):762-6. doi: 10.1378/chest.106.3.762.
To evaluate the prevalence and response to therapy of Strongyloides stercoralis infection in immigrant patients with asthma from areas endemic for Strongyloides.
In all patients, we performed a complete history and physical examination, complete blood cell counts (CBC), S stercoralis serologic tests, spirometry, and evaluated three stool samples for ova and parasites. Patients treated for S stercoralis infection had follow-up CBC, spirometry, serologic tests, and at least three additional stool examinations to confirm eradication of the parasite.
Ambulatory and hospitalized patients who were referred to the respiratory medicine clinic of a general hospital for the evaluation and treatment of asthma.
Forty-five asthmatic adults, representing 12 endemic countries, ranging in age from 20 to 76 years, were prospectively evaluated.
Six of 45 patients were infected with S stercoralis, which yielded a prevalence of 13 percent. The patients with asthma and S stercoralis infection had higher blood eosinophil counts (p = 0.006) and were younger (p = 0.006) compared with patients with only asthma. There was no difference in the duration of asthma, spirometry, or steroid use between the two groups. Patients with S stercoralis and asthma tended to be more recent immigrants (p = 0.05). Five of the six patients with S stercoralis agreed to be treated with thiabendazole but only four returned for follow-up evaluation. All four patients had eradication of S stercoralis infection confirmed by negative stool examinations and a decline in S stercoralis serology (160 +/- 25 percent vs 13 +/- 13 percent, p = 0.03). All four patients had a decline in total blood eosinophil counts (2,476 +/- 832 cells per cubic millimeter vs 551 +/- 138 cells per cubic millimeter, p = 0.03) without a clinical improvement in asthma.
Our data suggest that patients with asthma from areas endemic for S stercoralis, who have elevated peripheral blood eosinophil counts, should be screened for S stercoralis infection. Successful eradication of S stercoralis, however, may not result in a clinical improvement of asthma.
评估来自类圆线虫病流行地区的移民哮喘患者中类圆线虫感染的患病率及治疗反应。
对所有患者进行完整的病史采集和体格检查、全血细胞计数（CBC）、类圆线虫血清学检测、肺功能测定，并对三份粪便样本进行虫卵和寄生虫检测。接受类圆线虫感染治疗的患者进行随访CBC、肺功能测定、血清学检测，并至少进行另外三次粪便检查以确认寄生虫已被根除。
转诊至一家综合医院呼吸内科门诊进行哮喘评估和治疗的门诊及住院患者。
前瞻性评估了45名哮喘成年患者，他们来自12个流行国家，年龄在20至76岁之间。
45名患者中有6名感染了类圆线虫，患病率为13%。与仅患哮喘的患者相比，患有哮喘和类圆线虫感染的患者血液嗜酸性粒细胞计数更高（p = 0.006）且年龄更小（p = 0.006）。两组在哮喘病程、肺功能测定或使用类固醇方面无差异。患有类圆线虫和哮喘的患者往往是新移民（p = 0.05）。6名类圆线虫感染患者中有5名同意接受噻苯达唑治疗，但只有4名返回进行随访评估。所有4名患者经粪便检查阴性及类圆线虫血清学下降（160±25%对13±13%，p = 0.03）确认类圆线虫感染已被根除。所有4名患者全血嗜酸性粒细胞计数均下降（每立方毫米2476±832个细胞对551±138个细胞，p = 0.03），但哮喘无临床改善。
我们的数据表明，来自类圆线虫病流行地区且外周血嗜酸性粒细胞计数升高的哮喘患者应筛查类圆线虫感染。然而，成功根除类圆线虫可能不会导致哮喘的临床改善。
