关键词: 粪类圆线虫, 高度感染, 临床特征

Abstract:

Objective To summarize the clinical features and treatment experience of Strongyloides stercoralis hyperinfection for a reference in the diagnosis and treatment of this chronic infection. Methods Retrospective analysis was conducted on the clinical data including general conditions, clinical manifestations, findings of laboratory tests, pathogen detection and imaging examination, treatment and prognosis from the patients with Strongyloides stercoralis hyperinfection admitted to Haikou People’s Hospital during January 2018 and September 2024. Results Six patients with Strongyloides stercoralis hyperinfection were included. All patients were males, farmers, aged ranging from 53 to 78 years old. Five of them had underlying diseases, including 2 cases with long-term use of glucocorticoids and 1 case with long-term use of antineoplastic agents. The clinical manifestations were dominated by cough and expectoration, accompanied by fever, nausea, vomiting, and abdominal pain. The main complications were respiratory failure and septic shock. Laboratory studies revealed that serum albumin levels were all decreased in the six patients, in whom elevated eosinophils counts were seen in two, and decreased eosinophils count was observed in one. Strongyloides stercoralis were detected in both sputum and feces in 6 patients, and also in gastric juice in 1 patient. Chest CT revealed multiple or scattered exudative lesions in both lungs in the 6 patients. Two patients were treated with albendazole combined with levamisole, improved and discharged, and were cured at 1-month follow-up. Another 4 patients received single albendazole, with failed control of the condition. They were discharged against medical advice, and died at 1-month follow-up. Conclusion Strongyloides stercoralis hyperinfection commonly occurs in immunocompromised individuals, with gastrointestinal and pulmonary symptoms as the main manifestations and a poor prognosis. Combined medication may lead to a better therapeutic effect, and early pathogen detection and standardized treatment are crucial for improving prognosis.

Key words: Strongyloides stercoralis, Hyperinfection, Clinical features