目的:我们描述了一例高度感染综合征,报告了一系列病例,并回顾了台湾已发表的圆线虫病病例。
方法:在医学记录数据库中确定了1988年至2020年在国立台湾大学医院(NTUH)和NTUH新楚分院的圆线虫病确诊病例。文献检索是通过Pubmed进行的,谷歌学者,并对台湾期刊文献系统进行索引,以确定1979年至2020年台湾已发表的圆线虫病病例。与人口统计有关的数据,潜在的医疗状况,临床表现,实验室发现,并提取结果。
结果:共发现117例圆线虫病,包括来自两家医院的20例以前未发表的病例和文献中已发表的97例病例。总的来说,85(73%)为男性,平均年龄为64岁(范围,6-95岁)。典型的症状如腹泻,咳嗽,皮疹仅占43%,37%,18%的病人,分别,而仅在48%的患者中发现了嗜酸性粒细胞增多。在41例(35%)和4例(3%)患者中发现了圆线虫高度感染综合征和播散性圆线虫病,分别。四名(3%)患者并发脑膜炎。在单变量分析中,年龄较大,既往有慢性阻塞性肺疾病或哮喘与过度感染或播散相关(分别为p=0.024和0.003).高度感染或播散性感染的死亡率为43%。
结论:Strongyionasis可引起严重的并发症和死亡。在台湾,迫切需要努力早期诊断圆线虫病,以改善圆线虫病患者的预后。
OBJECTIVE: We described a case of Strongyloides
hyperinfection syndrome, reported a case series, and reviewed published cases of strongyloidiasis in Taiwan.
METHODS: Confirmed cases of strongyloidiasis at the National Taiwan University Hospital (NTUH) and NTUH Hsin-Chu Branch from 1988 to 2020 were identified in the medical record database. Literature search was carried out through Pubmed, Google Scholar, and Index to Taiwan Periodical Literature System to identify published cases of strongyloidiasis in Taiwan from 1979 to 2020. Data pertaining to the demographics, underlying medical conditions, clinical manifestations, laboratory findings, and outcomes were extracted.
RESULTS: A total of 117 cases of strongyloidiasis were identified, including 20 previously unpublished cases from the two hospitals and 97 published cases in the literature. Overall, 85 (73%) were male and the mean age was 64 years (range, 6-95 years). Classical symptoms such as diarrhea, cough, and skin rash were only observed in 43%, 37%, and 18% of the patients, respectively, whereas eosinophilia at presentation was only found in 48%. Strongyloides
hyperinfection syndrome and disseminated strongyloidiasis were identified in 41 (35%) and 4 (3%) patients, respectively. Four (3%) patients had concurrent meningitis. In univariable analysis, being older and having pre-existing chronic obstructive pulmonary disease or asthma were associated with
hyperinfection or dissemination (p = 0.024 and 0.003, respectively). The mortality rate was 43% among those with
hyperinfection or disseminated infection.
CONCLUSIONS: Strongyloidiasis can cause serious complications and mortality. Efforts to diagnose strongyloidiasis early are urgently needed to improve the outcome of patients with strongyloidiasis in Taiwan.