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被误诊为格林-巴利综合征的播散性类圆线虫病:寄生虫感染病原微生物高通量基因测序的价值
Authors Song P , Li H, Liu T, Liu Y, Ma X, Su L
Received 27 July 2022
Accepted for publication 12 September 2022
Published 22 September 2022 Volume 2022:15 Pages 5601—5607
DOI https://doi.org/10.2147/IDR.S381298
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Suresh Antony
Background: With the widespread use of steroids and immunosuppressants in mainland China, disseminated strongyloidiasis is becoming a severely underestimated tropical disease due to the lack of disease-specific manifestations and well-established diagnostic methods.
Case Presentation: Here, 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 ICU due to the excessive strongyloidiasis burden.
Conclusion: This case highlights the combined application of mNGS and traditional testing in the clinical diagnosis of difficult and critical parasitic infections in immunocompromised patients. mNGS is a new, adjunct diagnostic method to rapidly screen for possible parasitic etiologies.
Keywords: disseminated strongyloidiasis, Guillain-Barré syndrome, mNGS