Lessnau K D, Can S, Talavera W
Cabrini Medical Center, New York Medical College, New York 10003.
Chest. 1993 Jul;104(1):119-22. doi: 10.1378/chest.104.1.119.
We describe a North American human immunodeficiency virus (HIV)-positive patient with Strongyloides stercoralis infection of the gastrointestinal tract, who required repeated "standard" courses of thiabendazole. Pulmonary infection with numerous roundworms developed, as suspected by bronchoalveolar lavage, and while he was receiving therapy, dissemination occurred. On autopsy, S stercoralis was recovered in the gastrointestinal tract, liver, lung, and heart. After a literature review, we conclude that HIV-positive patients have a higher risk of dissemination and "standard" treatment failure. This may occur without elevation of IgE or eosinophilia. Those patients may require prolonged courses of thiabendazole or alternatively ivermectin therapy.
我们描述了一名北美人类免疫缺陷病毒（HIV）阳性患者，其胃肠道感染了粪类圆线虫，需要反复接受“标准”疗程的噻苯达唑治疗。正如支气管肺泡灌洗所怀疑的那样，患者出现了大量蛔虫引起的肺部感染，并且在接受治疗期间发生了播散。尸检时，在胃肠道、肝脏、肺和心脏中均发现了粪类圆线虫。经过文献回顾，我们得出结论，HIV阳性患者发生播散和“标准”治疗失败的风险更高。这可能在无IgE升高或嗜酸性粒细胞增多的情况下发生。这些患者可能需要延长噻苯达唑疗程或改用伊维菌素治疗。
