Strongyloidiasis (strongyloidosis)

ԴҡҸҴԴ˹Strongyloides stercoralis äš ͧ͹(tropic subtropic) ѹ͡ ҹҤ Ѻ..2523-2524ѵԴҸԴԴ 0.43 ͡ҡջԡҧջѿ Ѱԡ ҧѹ͡§ͧ кҴͧäҸԴҴöҧҹ ѹҧѺҸ֡ѺԴ֧ԹԨä

ԴäҡҸԴǹҡѺҴѹ Ҵѡѹ ˭äѧҧ͹ѹ ä leukemia, lymphoma, SLE, ä͹ Ѻѹ ҧ͡ҡ١ҸͧҨ١á͹ԴԴ ѡ ѵ§Ե͹ҧ٧ ѨغѹҸԴö١ҸԴǹҡԹԨ͹ҧҪ ѡ

ǧԵ ҸԴǧԵšҸԴ ѹѺѧѧdzduodenum jejunum Ѻҧѧ ǹشлѺب͡͹ rhabditiform larvae ѡ͡ҡѹش͡ҡѧ͡ҡҧлѺب

͹ rhabditiform ԹԭԺ ѧѹ ҧ͹Դ rhabditiform ١ѡ͡ ԭԺҺسǴӹ ¡ǧԵǧԵԹ (free-living cycle direct cycle)

س ͹rhabditiform Թԭ͹Դ (filariform) ͹Ҵ͹ ҳ 400 ͹ ٹҧҳ 10-12 ͹͹Դö˹ѧ شʹʹͧҡ͹١ԵԴʹʹʹ ʹ͹ԭԺҹ͡ҧԹǹ ١׹ŧҧԹ ¡ǧԵǧԵԵ (parasitic cycle indirect cycle)

ҧó ǧԵա˹Դҧ͹ rhabditiform ԭԺ͹Դ(filariform) ѹ ͧ͹ rhabditiform Թ͹͹Դѧ ˹ѧͺҡ˹ѡ ١ԵѺԭԺʹ ١׹ŧ ¡ԴǧԵautoinfection ǧԵҸ S. stercoralis öҧҹ͡ҡкҴҹ

ҡҧԤҸҾԴ Strongyloides stercoralis ǹҡԴҡ ҡҡҺͧԴҸԴ ǹҡҺǨ͹ҸԴبҡ ǹҡմ (anemia) ԵԵԴ eosinophils٧ Ѻعç ԵԴ eosinophils ѡ ҸäҧͧҡѹԴCMI (cell-mediated immunity) ͧ

͹˹ѧԴҡѹ˹ѧ Դ (linear urticarial rash) ҧشʹ͡˹ѧdz͹ͧҡ˹ѧ͹ҧҸԴ ֧¡ larvacurrens ᷹¡ cutaneous larva migran ҸҾѡʺǹ˭Դeosinophils ҧҡҧ˹ѧҧ ҡҧ

ʹ ҡҡá͹ ʹѡʺ ҸҾاʹ(congestion) ѡʺʹ اʹ ѧʹ

óҡ ҡ¹ ͧԹѺѺ ͧ١ ҸҾѡɳҨѧ ҡ villi ͧ˴ ͹ crypts ͧ ͡ҡѧöǨ͹ileum, jejunum, duodenum, Ѻ͹ ѧ˭dzcolon ˹ͧҡҡ

شͧ Դ meningitis͹öҡѹѧ ҸҾͧҴ(micro-infarcts) ͧǹ cerebrum cerebellum ͡ҡҨ͹epidural, subdural subarachnoid

Disseminated strongyloidiasis

ԴóԴ Strongyloidessteroralis ҧ͹ ѹͧ Ѻѹ corticosteroid Դ Դҡ (hyperinfection)ǧԵ autoinfection ͹Դ͡͡ԴҸҾҧ¡ disseminatedstrongyloidiasis Դѡʺҧعç ͧdzsigmoid rectum ѡʺҧعç ͹ filariform ҡdzdzѡʺǹҡԴ eosinophils ͹ҨԵԴѡʺҧعç͹Ѻävisceral larva migrans ԴѺʹԴѵ͹ҧ٧

ԹԨä Ǩ͹rhabditiform ͹Դ (infective filariform) ب ͧٴҡdzduodenum ҡdz ҧҨǨҡǨԸѧ ǨҸԴ ԹԨä͹ҧӺҡҨӹǹҸ͹ҧ ǨҸҨ˵˹ҸԴҧҹ͡ҡѧҨǨҡҧٹ Ը indirect hemagglutination,complement fixation, immunofluorescence enzyme-linked immunosorbentassay (ELISA)