PDF(Pubmed)
Abstract：
The symptoms of disseminated strongyloidiasis are not typical, and it is difficult for clinicians to identify strongyloidiasis in some non-endemic areas. We report a 70-year-old woman who was diagnosed with Guillain-Barré syndrome due to autonomic disturbance, symmetrical bulbar palsy, and lower-motor-nerve damage in the extremities; her symptoms continued to worsen after hormone and immunoglobulin therapy. Later, parasitic larvae were found in the patient\'s gastric fluid, and metagenomic next generation sequencing (mNGS) detection of bronchoalveolar-lavage fluid also found a large number of Strongyloides roundworms. The patient was diagnosed with disseminated strongyloidiasis. The patient was given albendazole for anthelmintic treatment, but died two days after being transferred to the intensive care unit due to the excessive strongyloidiasis burden. In recent years, mNGS has been increasingly used in clinical practice, and is becoming the main means of detecting strongyloides stercoralis in non-endemic areas. Especially during the corona virus disease 2019 pandemic, mNGS technology has irreplaceable value in identifying the source of infection.
摘要：
播散性圆线虫病的症状不典型,在一些非流行地区，临床医生很难识别线虫病。我们报道了一名70岁的女性，她因自主神经紊乱而被诊断出患有格林-巴利综合征，对称球麻痹,和四肢下运动神经损伤；激素和免疫球蛋白治疗后，她的症状继续恶化。稍后，在病人的胃液中发现了寄生幼虫，而宏基因组下一代测序(mNGS)检测支气管肺泡灌洗液中也发现了大量的类圆线虫。患者被诊断为播散性圆线虫病。患者给予阿苯达唑驱虫治疗，但在转至重症监护室两天后因过大的线虫病负担而死亡。近年来,mNGS越来越多地用于临床实践，并正在成为非流行地区检测胸骨圆线虫的主要手段。特别是在2019年冠状病毒病大流行期间，mNGS技术在确定感染源方面具有不可替代的价值。
