Journal
INFECTION AND DRUG RESISTANCE
Volume 15, Issue -, Pages 5601-5607Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/IDR.S381298
Keywords
disseminated strongyloidiasis; Guillain-Barr? syndrome; mNGS
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Funding
- Natural Science Foundation of Shandong Province, China [ZR2021QH334]
- Shandong Provincial Hospital Scientific Research Incubation Fund [2020FY023]
- Medical Research Development Fund Project (Clinical and Basic Research Project -Beijing Kangmeng Charity Foundation)
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This case study illustrates the importance of using metagenomic Next Generation Sequencing (mNGS) in combination with traditional testing for diagnosing challenging parasitic infections in immunocompromised patients. mNGS is a valuable adjunct method for rapid screening of potential parasitic causes.
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-Barre 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.
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