Parasitic infections in the United States are mostly seen in immigrants and travelers. In many cases, pulmonary and intensive care physicians fail to consider parasitic disease, which can result in delayed diagnosis and adverse outcomes. Almost 2,000 cases of imported malaria are diagnosed in the United States each year. Severe cases can be confused with bacterial sepsis (shock, lactic acidosis, pneumonia, renal failure, respiratory failure, and jaundice). In contrast to bacterial sepsis, survival is improved by restrictive fluid therapy. Parenteral artesunate is licensed to treat severe cases but may not be readily accessible. Strongyloidiasis is endemic in warm and most tropical regions. Chronic strongyloidiasis causes few symptoms and can persist for decades after the patient leaves the endemic region. Treatment with corticosteroids may lead to hyperinfection, which may present with bacteremia and meningitis due to enteric organisms, pulmonary hemorrhage, and gastrointestinal pain, bleeding or obstruction. Treatment with ivermectin can be curative if initiated early. Cystic echinococcosis can present as pulmonary mass. Paragonimus presents with hemoptysis, pulmonary nodules, and/or pleural effusions, and usually with eosinophilia. Endemic regions include not only East Asia, but also Southeast Asia, west Africa, the Pacific coast of Latin America, and even North America. Other parasitic infections can involve the lungs. This article aims to provide awareness of the most clinically relevant parasitic infections seen in pulmonary and critical care medicine.

中文翻译：

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肺部和重症监护病房患者的寄生虫感染：表现、诊断和治疗。


在美国，寄生虫感染主要见于移民和旅行者。在许多情况下，肺病和重症监护医生没有考虑寄生虫病，这可能导致延误诊断和不良后果。美国每年诊断出近 2,000 例输入性疟疾病例。严重病例可能与细菌性脓毒症（休克、乳酸性酸中毒、肺炎、肾功能衰竭、呼吸衰竭和黄疸）相混淆。与细菌性脓毒症相比，限制性液体治疗可提高生存率。肠外青蒿琥酯获准用于治疗严重病例，但可能不容易获得。类圆线虫病在温暖地区和大多数热带地区流行。慢性类圆线虫病很少引起症状，并且在患者离开流行地区后可持续数十年。皮质类固醇治疗可能导致重度感染，可能表现为肠道微生物引起的菌血症和脑膜炎、肺出血和胃肠道疼痛、出血或梗阻。如果及早开始，伊维菌素治疗可以治愈。囊型棘球蚴病可表现为肺部肿块。并殖吸虫表现为咯血、肺结节和/或胸腔积液，通常伴有嗜酸性粒细胞增多。流行地区不仅包括东亚，还包括东南亚、西非、拉丁美洲太平洋沿岸，甚至北美。其他寄生虫感染可能涉及肺部。本文旨在提高人们对肺病和重症监护医学中临床相关性最强的寄生虫感染的认识。