A case of fatal malabsorption syndrome caused by strongyloidiasis complicated with isosporiasis and human cytomegalovirus infection

분선충, Isospora 및 인형세포거대바이러스에 감염된 흡수불량 증후군 1례

This 54-year-old Korean coal miner soBered from continuous watery diarrhea and weight loss after corticosteroid treatment(${\beta}-methasone$, 4 mg daily for 1 week) due to hip-bone fracture in January 1991. Except for the short therapy f steroid, no other histories were contributory. The malabsorption syndrome was aggravated while the case was treated under the impression of amebiasis or intestinal tuberculosis. AIDS antibody test by EIA was negative and quantitative analysis of serum immunoglobulins was in normal ranges. Nine months after the onset of symptoms, the case was diagnosed as malabsorption syndrome caused by complected and aggravated infection by Strengyleides stercoralis, Isospora and cytomegalovirus in the small intestine, which were proved by stool examination and duodenal biopsy. His clinical course became worse even after high-dosaged and prolonged albendazole treatment for strongyloidiasis with supportive quid therapy. The patient was discharged in hopeless status in November, 1991 and died after one week at home.

환자는 54세 광부로 1991년 1월 낙반사고로 인해 가벼운 골반 골절상을 받았었고, 골절상은 완치되었으나 설사가 지속하고 체중이 심하게 감소하였다. 발병 약 9 개월만에 시행한 대변검사 및 조직 검사에서 분선충중(strongyloidiasis), 포자충중(isosporiasis) 및 인형 세포거대바이러스(heman cytomegalovirus)에 감염된 사실이 확인되었다. Albendazole로 치료하였으나 약 2개월 후 근로복지공사 장성병원에서 난치 상환 하에 퇴원하였으며, 퇴원 1주 후 사망하였다.