斯特朗基洛伊德过度感染综合征是由用于胎儿肺部发育的单剂量德克萨米他所引发的
John Meisenheimer Vii1, Jaraad Dattadeen1, Meredith Thomley2
1Internal Medicine, University of South Florida, Tampa, USA.
一次剂量的皮质类固醇引发了罕见且严重的Strongyloides过度感染综合征在一个患者与先前存在的自身感染. 这一案例凸显了临床医生需要认出有风险的个体,并仔细考虑使用皮质类固醇的必要性.
科学领域:
- 寄生虫学的寄生虫学
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 斯特朗格洛伊德过度感染综合征 (SHS) 是一种罕见但可能致命的斯特朗格洛伊德 stercoralis 感染并发症.
- 皮质类固醇是已知的引发SHS的个人与Strongyloides自感染.
- 即使是单剂量的皮质类固醇也被建议导致SHS.
研究的目的:
- 报告一个单一的SHS病例,由单一剂量德克萨米他引起.
- 为了强调皮质类固醇在患有潜在斯特朗基洛伊德感染的患者中使用的风险.
主要方法:
- 病例报告详细介绍了一名在接受单次剂量德克萨米他后发展SHS的患者.
- 记录了临床表现,诊断结果 (液培养对Strongyloides阳性),以及治疗结果.
- 对皮质类固醇诱导的SHS现有文献的审查.
主要成果:
- 一名怀孕的患者在服用单次8毫克德克萨米他剂后8天就出现了SHS.
- 患者出现了格拉姆阴性细菌病,肠道病变和过敏性肺炎.
- 通过治疗ivermectin和albendazole获得了成功的恢复.
结论:
- 这一案例强调,即使是单剂量的皮质类固醇也可以在易受感染的个体中引发SHS.
- 临床医生必须在处方皮质类固醇之前,在患有相关风险因素的患者中保持对Strongyloides的高度怀疑指数.
- 对这种关联的认识对于预防与SHS相关的严重发病率和死亡率至关重要.
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