1
|
Lupia T, Crisà E, Gaviraghi A, Rizzello B, Di Vincenzo A, Carnevale-Schianca F, Caravelli D, Fizzotti M, Tolomeo F, Vitolo U, De Benedetto I, Shbaklo N, Cerutti A, Fenu P, Gregorc V, Corcione S, Ghisetti V, De Rosa FG. Strongyloides spp. and Cytomegalovirus Co-Infection in Patient Affected by Non-Hodgkin Lymphoma. Trop Med Infect Dis 2023; 8:331. [PMID: 37368749 DOI: 10.3390/tropicalmed8060331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
To our knowledge, we have described the first case of Strongyloides/Cytomegalovirus (CMV) concomitant infection that occurred in a European country. The patient was a 76-year-old woman affected by relapsed non-Hodgkin lymphoma who presented interstitial pneumonia with a rapidly progressive worsening of respiratory insufficiency, leading to cardiac dysfunction and consequent death. CMV reactivation is a common complication in immunocompromised patients, while hyperinfection/disseminated strongyloidiasis (HS/DS) is rare in low endemic regions, but has been widely described in Southeast Asia and American countries. HS and DS are two consequences of the failure of infection control by the immune system: HS is the uncontrolled replication of the parasite within the host and DS the spreading of the L3 larvae in organs other than the usual replication sites. Only a few cases of HS/CMV infection have been reported in the literature, and only in one patient with lymphoma as an underlying disease. The clinical manifestations of these two infections overlap, usually leading to a delayed diagnosis and a consequent poor outcome.
Collapse
Affiliation(s)
- Tommaso Lupia
- Unit of Infectious Diseases, Cardinal Massaia, 14100 Asti, Italy
| | - Elena Crisà
- Unit of Oncology and Haematology, Candiolo Cancer Institute, 10060 Candiolo, Italy
| | - Alberto Gaviraghi
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | - Barbara Rizzello
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | | | | | - Daniela Caravelli
- Unit of Oncology and Haematology, Candiolo Cancer Institute, 10060 Candiolo, Italy
| | - Marco Fizzotti
- Unit of Oncology and Haematology, Candiolo Cancer Institute, 10060 Candiolo, Italy
| | - Francesco Tolomeo
- Unit of Oncology and Haematology, Candiolo Cancer Institute, 10060 Candiolo, Italy
| | - Umberto Vitolo
- Unit of Oncology and Haematology, Candiolo Cancer Institute, 10060 Candiolo, Italy
| | - Ilaria De Benedetto
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | - Nour Shbaklo
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | | | - Piero Fenu
- Healthcare Management, IRCCS Candiolo, 10100 Candiolo, Italy
| | - Vanesa Gregorc
- Unit of Oncology and Haematology, Candiolo Cancer Institute, 10060 Candiolo, Italy
| | - Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
- School of Medicine, Tufts University, Boston, MA 02111, USA
| | - Valeria Ghisetti
- Microbiology Unit, Amedeo di Savoia Hospital, 10100 Turin, Italy
| | - Francesco Giuseppe De Rosa
- Unit of Infectious Diseases, Cardinal Massaia, 14100 Asti, Italy
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| |
Collapse
|
2
|
Bdioui A, Bchir A, Missaoui N, Hmissa S, Mokni M. Histopathological diagnosis of strongyloidiasis hyperinfection in Tunisian patient with hodgkin lymphoma: Case report. Ann Med Surg (Lond) 2021; 66:102367. [PMID: 34040766 PMCID: PMC8141501 DOI: 10.1016/j.amsu.2021.102367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Strongyloides stercoralis, an intestinal nematode, is commonly dispersed throughout the tropical and subtropical regions. Strongyloides stercoralis infection typically contributes to an asymptomatic chronic disease which can remain hidden for decades. However, in immunocompromised patients, the hyperinfection can take place, causing high mortality rates. Case presentation A 45 year-old Tunisian women, with heavy medical history, suffering of stage 3 classic Hodgkin lymphoma under treatment; presented with complaints of epigastric pain, nausea, vomiting. Gastroduodenoscopy showed duodenal and gastric erythematous and ulcerated mucosa. Histological assessment showed chronic infiltration with a large amount of eosinophils around numerous helminth forms identified as larvae of Strongyloides stercoralis. Conclusion Early detection of Strongyloides stercoralis infection in immunocompromised patients is life saving and avoids fatality caused by hyperinfection or systemic dissemination. Routine stool examination may be negative, so histopathological identification of the parasite in tissue sections provides the definite diagnosis.
Collapse
Key Words
- BEACOPP, Bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone
- Case report
- Diagnosis
- Gastrointestinal infection
- HIV, Human immunodeficiency virus
- HTLV1, Human T-lymphotropic virus
- Histopathology
- Hodgkin lymphoma
- M.O.P.P, Nitrogen mustard, oncovin, prednisone, procarbazine
- Strongyloides stercoralis
Collapse
Affiliation(s)
- Ahlem Bdioui
- Pathology Department, Sahloul University Hospital, 4002, Sousse, Tunisia
| | - Ahlem Bchir
- Pathology Department, Farhat Hached University Hospital, 4000, Sousse, Tunisia
| | - Nabiha Missaoui
- Faculty of Sciences and Techniques of Sidi Bouzid, Kairouan University, Kairouan, Tunisia
| | - Sihem Hmissa
- Pathology Department, Sahloul University Hospital, 4002, Sousse, Tunisia
| | - Moncef Mokni
- Pathology Department, Farhat Hached University Hospital, 4000, Sousse, Tunisia
| |
Collapse
|
3
|
Strongyloides stercoralis infection complicating the central nervous system. NEUROPARASITOLOGY AND TROPICAL NEUROLOGY 2013; 114:229-34. [DOI: 10.1016/b978-0-444-53490-3.00017-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
4
|
Abdelrahman MZ, Zeehaida M, Rahmah N, Norsyahida A, Madihah B, Azlan H, Nazlee WZ. Fatal septicemic shock associated with Strongyloides stercoralis infection in a patient with angioimmunoblastic T-cell lymphoma: a case report and literature review. Parasitol Int 2012; 61:508-11. [PMID: 22575692 DOI: 10.1016/j.parint.2012.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Revised: 03/25/2012] [Accepted: 04/25/2012] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Strongyloides stercoralis infection can persist in the host for several decades, and patients with cancer and other clinical conditions who are exposed to immunosuppressive therapy are at risk of developing hyperinfection. CASE REPORT This is a case of angioimmunoblastic T-cell lymphoma (AITL) in a patient with lymphadenopathy and bulky neck mass. Severe sepsis and episodes of diarrhea were observed upon the first cycle of cyclophosphamide, doxorubicin, oncovin (vincristine) and prednisone (CHOP) regime chemotherapy preceded by high dose of dexamethasone. There was Klebsiella pneumoniae bacteremia and moderate eosinophilia. Rhabditiform S. stercoralis larvae were observed in the stool, and this was confirmed by real-time PCR. Strongyloides-specific IgG and IgG4 were also positive. The patient was treated with oral albendazole (400mg/day) for 3 days and intravenous tazocin (4.5gm/6 hours) for 5 days; however he succumbed following multi-organ failure. CONCLUSION This is likely a case of Strongyloides hyperinfection with secondary bacteremia.
Collapse
Affiliation(s)
- M Z Abdelrahman
- Department of Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | | | | | | | | | | | | |
Collapse
|
5
|
Issa H, Aljama MA, Al-Salem AH. Strongyloides stercoralis hyperinfection in a post-renal transplant patient. Clin Exp Gastroenterol 2011; 4:269-71. [PMID: 22235169 PMCID: PMC3254203 DOI: 10.2147/ceg.s19705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Strongyloides stercoralis is an intestinal nematode that is able to infect the host tissue and persist asymptomatic for many years through autoinfection. It causes life-threatening hyperinfection in immunocompromised hosts. This report describes a rare case of strongyloidiasis in a 40-year-old male following renal transplant, which was diagnosed by colonoscopic biopsy. The literature on the subject is also reviewed.
Collapse
Affiliation(s)
- Hussain Issa
- Department of Internal Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | | |
Collapse
|
6
|
Abstract
A West Indian man who was infected with Strongyloides stercoralis developed small intestinal obstruction. Treatment with thiabendazole did not relieve the obstruction which was found at laparotomy to be due to a poorly differentiated small intestinal lymphoma. There was no blood eosinophilia or accumulation of eosinopohils in the sites of infection. There was no reaction in the skin to delayed hypersensitivity antigens and the blood T lymphocyte count and serum C3 levels were low. From these findings and a review of the literature it was concluded that the immune response in man to Strongyloides stercoralis may depend on T lymphocyte mediated reactions including granuloma formation, and mast cell and eosinophil responses in tissues. We suggest that the association of strongyloides hyperinfection and small bowel lymphoma in this patient may not have been fortuitous. The lymphoma may have led to a reduction in cellular immunity, with the subsequent development of strongyloides hyperinfection.
Collapse
|
7
|
Fardet L, Généreau T, Poirot JL, Guidet B, Kettaneh A, Cabane J. Severe strongyloidiasis in corticosteroid-treated patients: case series and literature review. J Infect 2006; 54:18-27. [PMID: 16533536 DOI: 10.1016/j.jinf.2006.01.016] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Revised: 01/18/2006] [Accepted: 01/22/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To describe the main features of severe strongyloidiasis in corticosteroid-treated patients METHODS We report on 3 cases of corticosteroid-treated patients with severe strongyloidiasis and review cases of severe strongyloidiasis in corticosteroid-treated patients reported in the literature. RESULTS One hundred and fifty-one cases of severe strongyloidiasis complicated a therapy with corticosteroids were evaluated. The mean age of the patients was 48+/-17 years and 71% were men. Corticosteroids were given for hematological malignancies in 34 (23%), systemic lupus erythematosus or vasculitis in 27 (18%), and nephropathy or renal transplantation in 32 (21%). At time of infection, the mean daily dosage of prednisone-equivalent was 52+/-42 mg (median: 40 mg) and 84% of patients had received a cumulative dosage of prednisone-equivalent higher than 1000 mg. The total duration of treatment ranged from 4 days to 20 years (6 months or less: 69%). Non-specific gastro-intestinal symptoms were reported in 91% of these patients associated or not with pulmonary complaints. Low-grade fever was present in 54% of patients. Fifty-nine patients (39%) experienced severe bacterial or yeast infection during the course of severe strongyloidiasis. Peripheral eosinophilia was detected at presentation in 32% of patients. Strongyloidiasis was usually confirmed by repeated stool examinations. Thiabendazole was the treatment the more widely used. Eighty-nine patients (59%) deceased during the course of the disease. CONCLUSIONS Severe strongyloidiasis is a risk in every corticosteroid-treated patient who has traveled to a soil-infested country, even if the contact was 30 years prior. This diagnosis should be suspected in patients who either experience unusual gastro-intestinal or pulmonary symptoms or suffer from unexplained Gram-negative bacilli sepsis.
Collapse
Affiliation(s)
- Laurence Fardet
- Hopital Saint-Antoine, Internal Medicine, Parasitology and Intensive Care Department, 184 rue du Fbg Saint-Antoine, 75012 Paris, France.
| | | | | | | | | | | |
Collapse
|
8
|
Abstract
INTRODUCTION Strongyloidiasis can result in severe forms in immunodepressed patients or those treated with prolonged corticosteroids. OBSERVATION A 59 year-old woman suffering from chronic kidney failure, treated for the past year by haemodialysis, was hospitalized for alteration in her general status of health and severe digestive problems. Three parasitological examinations of the faeces revealed the presence of Strongyloides stercoralis larvae, although she had never spent time in the Tropics. The outcome was rapidly good following treatment with thiabendazole. DISCUSSION Some severe forms of strongyloidiasis occurring in immunodepressed or chronic dialysed patients can be fatal in the absence of early management.
Collapse
Affiliation(s)
- Khadija Hachim
- Service de néphrologie-hémodialyse, CHU Ibn Rochd, Casablanca, Maroc
| | | | | | | | | |
Collapse
|
9
|
Lim S, Katz K, Krajden S, Fuksa M, Keystone JS, Kain KC. Complicated and fatal Strongyloides infection in Canadians: risk factors, diagnosis and management. CMAJ 2004; 171:479-84. [PMID: 15337730 PMCID: PMC514646 DOI: 10.1503/cmaj.1031698] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Strongyloidiasis, which is caused by the nematode Strongyloides stercoralis, is a common and persistent infection, particularly in developing countries. In the setting of compromised cellular immunity, it can result in fulminant dissemination with case-fatality rates of over 70%. The majority of new Canadian immigrants come from countries where Strongyloides is highly endemic; therefore, the burden of Strongyloides may be underappreciated in Canada. Because early diagnosis and therapy can have a marked impact on disease outcome, screening for this infection should be considered mandatory for patients who have a history of travel or residence in a disease-endemic area and risk factors for disseminated disease (e.g., corticosteroid use and human T-lymphotropic virus type I infection).
Collapse
Affiliation(s)
- Sue Lim
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto General Hospital--University Health Network, Toronto, Ont
| | | | | | | | | | | |
Collapse
|
10
|
Abstract
Strongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. S. stercoralis is unique among intestinal nematodes in its ability to complete its life cycle within the host through an asexual autoinfective cycle, allowing the infection to persist in the host indefinitely. Under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome, characterized by increased numbers of infective filariform larvae in stool and sputum and clinical manifestations of the increased parasite burden and migration, such as gastrointestinal bleeding and respiratory distress. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment and human T-lymphotropic virus type 1 infection are the two conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelmintic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome as well as for primary and secondary prevention of hyperinfection in patients whose exposure history and underlying condition put them at increased risk.
Collapse
Affiliation(s)
- Paul B Keiser
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA
| | | |
Collapse
|
11
|
Abstract
PURPOSE This report describes a case of disseminated strongyloidiasis in a child receiving chemotherapy for T-cell lymphoblastic lymphoma. PATIENT AND METHODS A 10-year-old boy became severely ill with disseminated strongyloidiasis 4 weeks after starting chemotherapy for T-cell lymphoblastic lymphoma. He responded to treatment with supportive care, antibiotics, and albendazole but required ivermectin to eradicate the strongyloides infection. CONCLUSION Disseminated strongyloidiasis is a severe, life-threatening complication of Strongyloides stercoralis infection that can occur in patients on immunosuppressive therapy, particularly when this therapy includes corticosteriods. In endemic areas, screening patients due to undergo immunosuppressive treatment and appropriate antistrongyloides treatment may be life saving. Ivermectin is the treatment of choice.
Collapse
Affiliation(s)
- J D Daubenton
- Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, South Africa
| | | | | |
Collapse
|
12
|
Aydin H, Doppl W, Battmann A, Bohle RM, Klör HU. Opportunistic strongyloides stercoralis hyperinfection in lymphoma patients undergoing chemotherapy and/or radiotherapy--report of a case and review of the literature. Acta Oncol 1994; 33:78-80. [PMID: 8142133 DOI: 10.3109/02841869409098386] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- H Aydin
- Dept. of Radiation Oncology, University of Giessen, Germany
| | | | | | | | | |
Collapse
|
13
|
Dutcher JP, Marcus SL, Tanowitz HB, Wittner M, Fuks JZ, Wiernik PH. Disseminated strongyloidiasis with central nervous system involvement diagnosed antemortem in a patient with acquired immunodeficiency syndrome and Burkitts lymphoma. Cancer 1990; 66:2417-20. [PMID: 2245399 DOI: 10.1002/1097-0142(19901201)66:11<2417::aid-cncr2820661129>3.0.co;2-g] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 45-year-old man presented with central nervous system involvement as the initial manifestation of disseminated infection with Strongyloides stercoralis. Several concurrent clinical factors contributed to this event, all related to the patient's immunosuppression, including high-grade lymphoma, corticosteroid therapy, and acquired immunodeficiency syndrome. This is only the third case of CNS involvement in disseminated strongyloidiasis diagnosed antemortem.
Collapse
Affiliation(s)
- J P Dutcher
- Department of Oncology, Montefiore Medical Center, Bronx, NY 10467
| | | | | | | | | | | |
Collapse
|
14
|
Genta RM, Miles P, Fields K. Opportunistic Strongyloides stercoralis infection in lymphoma patients. Report of a case and review of the literature. Cancer 1989; 63:1407-11. [PMID: 2646009 DOI: 10.1002/1097-0142(19890401)63:7<1407::aid-cncr2820630729>3.0.co;2-i] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Strongyloides stercoralis is an intestinal parasite that may cause fatal opportunistic infections in immunocompromised patients. Herein is reported a patient who developed fatal disseminated strongyloidiasis 6 weeks after the initiation of chemotherapy for a large cell lymphoma of the small intestine. After reviewing the clinical and epidemiologic features of 16 other cases of disseminated strongyloidiasis in patients with malignant lymphomas, the currently available laboratory methods for the diagnosis of this parasite are outlined. Because uncomplicated infections are treatable, candidates for chemotherapy or immunosuppression with a relevant geographic history should be screened for S. stercoralis prior to the initiation of the treatment.
Collapse
Affiliation(s)
- R M Genta
- Department of Pathology and Laboratory Medicine, Veterans Administration Medical Center, Cincinnati, Ohio 45220
| | | | | |
Collapse
|
15
|
Hong SJ, Shin JS, Kim SY. [A case of strongloidiasis with hyperinfection syndrome]. KISAENGCH'UNGHAK CHAPCHI. THE KOREAN JOURNAL OF PARASITOLOGY 1988; 26:221-226. [PMID: 12811051 DOI: 10.3347/kjp.1988.26.3.221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 73-year-old Korean male was admitted to Jeil hospital with clinical complaints of backache, cough, sputum, vomiting and diarrhea. He had a history of long term administration of prednisolone. At admission he was comatose and showed generalized pitting edema and anasarca. Laboratory data revealed leukocytosis, hyperproteinemia with hypoalbuminemia, sepsis, anemia and brown-colored urine. Stool examination revealed rhabditiform nematode larvae. By fecal cultivation, filariform larvae of Strogyloides were obtained and the patient was diagnosed as hyperinfection syndrome due to S. stercoralis infection. On the 3rd day of hospitalization, albendazole treatment was started and continued for 4 days. On the 7th dsy of hospitalization, sputum revealed filariform larvae. Total 619 parasitic adult females, expelled by chemotherapy, were collected from the diarrheal stool. However, the patient was discharged hopelessly and died at home.
Collapse
Affiliation(s)
- Sung Jong Hong
- Department of Parasitology, College of Medicine, Gyeong-Sang National University, ChinJu, Korea
| | | | | |
Collapse
|
16
|
Choi KS, Whang YN, Kim YJ, Yang YM, Yoon K, Kim JJ, Min DY, Lee KT. [A case of hyperinfection syndrome with Strongyloides stercoralis]. KISAENGCH'UNGHAK CHAPCHI. THE KOREAN JOURNAL OF PARASITOLOGY 1985; 23:236-240. [PMID: 12888666 DOI: 10.3347/kjp.1985.23.2.236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A case of Strongyloides stercoralis infection wss experienced in a 73-year old Korean female patient, was hospitalized with relapse of cholecystitis. The patient developed cough and dyspnea 17 days after the admission. On the 27th hospitalized day, diarrhoea, nausea, vomiting and abdominal pain started. A number of parasitic larvae were incubated at 25 degrees C for 2 days. Typical fork tailed filariform larvae of S. stercoralis (Bavay, 1876) Stiles and Hassall, 1902, were identified after cultivation. There was no improvement of diarrhoea after the medication with mebendazole. After the administration of thiabendazole, however, diarrhoea was stopped. On the 6th day of medication, S. stercoralis larvae were no more detected, and thereafter no larva was observed by repeated stool examinations upto 2 months after chemotherapy. The patient had the history of administration of steroid for articular rheumatism. Therefore this case seems to be a hyperinfection of S. stercoralis due to an autoinfection and to be the first report on the hyperinfected strongyloidiasis in Korea. Related literature was briefly reviewed.
Collapse
|
17
|
Bezares RF, Carreras LO, Marin CA, Rodriguez Fuchs CA, de Tezanos Pinto M, Nuñez EN. Fatal strongyloides stercoralis hyperinfection in acute leukaemia. Lancet 1983; 1:481. [PMID: 6131202 DOI: 10.1016/s0140-6736(83)91484-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
18
|
Pieterse AS. Test and teach Number Forty-Four Part 2. Pathology 1983. [DOI: 10.3109/00313028309085182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
19
|
|
20
|
Strongyloïdose mortelle des sujets immunodéprimés. Revue de la littérature à propos d'un nouveau cas. Med Mal Infect 1982. [DOI: 10.1016/s0399-077x(82)80050-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
21
|
West BC, Wilson JP. Subconjunctival corticosteroid therapy complicated by hyperinfective strongyloidiasis. Am J Ophthalmol 1980; 89:854-7. [PMID: 7386565 DOI: 10.1016/0002-9394(80)90179-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A 57-year-old man was treated for a corneal ulcer with a penetrating keratoplasty, followed by six weeks of a regimen of 4 to 8 mg of dexamethasone injected subconjunctivally daily. Before therapy, he was clinically well and 10% eosinophils were noted on his differential white blood cell count. He developed a gastric peptic ulcer with hemorrhage and severe strongyloidiasis of the stomach and duodenum that worsened as the ulcer responded to medical therapy. The strongyloidiasis resulted in physiologic gastric outlet obstruction by decreasing gastrointestinal motility. There was evidence of hyperinvasive and disseminated strongyloidiasis, complicated by meningitis and Serratia marcescens bacteremia. He survived and received thiabendazole treatment for strongyloidiasis, which was successful. Subconjunctival corticosteroids caused a systemic effect that changed asymptomatic Strongyloides infection into hyperinvasive strongyloidiasis.
Collapse
|
22
|
Jaramillo D, León W, Cárdenas V, Cortés A. Reiter's syndrome, immunodepression and strongyloidiasis. Report of a fatal case. J Cutan Pathol 1978; 5:200-8. [PMID: 701535 DOI: 10.1111/j.1600-0560.1978.tb00957.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We present the case of a 52-year-old white male who showed arthritis, conjunctivitis and non-gonococcal urethritis. Besides those manifestations, the patient also showed mucocutaneous lesions that were both clinically and histologically indistinguishable from those of pustular psoriasis. Due to the severity of the disease it was necessary to treat this patient with corticosteroids and immunosuppressors. With this therapy the clinical manifestations of Reiter's Syndrome disappeared but sudden abdominal and bronchopulmonary symptoms complicated the picture and the patient died in a septical shock. The autopsy findings revealed massive Strongyloidiasis with the presence of larvae in several organs, particularly in the intestinal wall, the lungs and the liver.
Collapse
|
23
|
Smith SB, Schwartzman M, Mencia LF, Blum EB, Krogstad D, Nitzkin J, Healy GR. Fatal disseminated strongyloidiasis presenting as acute abdominal distress in an urban child. J Pediatr 1977; 91:607-9. [PMID: 908981 DOI: 10.1016/s0022-3476(77)80513-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
24
|
Piller NB. A comparison of the effect of benzopyrones and other drugs with anti-inflammatory properties on acid and neutral protease activity levels in various tissues after thermal injury. BRITISH JOURNAL OF EXPERIMENTAL PATHOLOGY 1976; 57:411-8. [PMID: 986829 PMCID: PMC2041167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Generally, the benzopyrones enhanced acid protease activity levels in the oedema fluid and the extracellular compartment of the skin. This is the region where thermal injury has its greatest impact. The proteolysis induced by the drugs in this region represents a means of rapidly reducing some of the derangements which the thermal injury has caused. Levamisole also enhanced acid protease activity levels in the serum and extracellular compartment of the skin 6 hours after thermal injury, while Reparil had the same effect at 24 hours. Generally the benzopyrones had little or no effect on neutral protease levels, while levamisole and Reparil caused their depression. The later effects could possibly be attributed to serum deactivation or to inhibition of their release. The enzyme enhancing activity of these drugs has been shown to correlate remarkably well with their oedema reducing ability. Generally, those which increased enzyme activity levels the most were the most effective in reducing the oedema. The cells upon which the drugs exert their effects in thermal oedema mainly seem to be the macrophages; the fibroblasts seem to be of secondary importance. This is to be contrasted with their action in the initial stages of lymphoedema where they are believed to stimulate the neutrophils. The net result of the proteolysis is many small fragments which can rapidly leave the injured tissue thus releasing the oedema fluid.
Collapse
|
25
|
Higenbottam TW, Heard BE. Opportunistic pulmonary strongyloidiasis complicating asthma treated with steroids. Thorax 1976; 31:226-33. [PMID: 781904 PMCID: PMC470389 DOI: 10.1136/thx.31.2.226] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A man aged 57 years who had lived most of his life in London, suffered from asthma which had begun during army service in Burma 37 years previously. Latterly he was treated with increasing doses of corticosteroids but his symptoms continued to worsen and he died of asthma. Necropsy revealed a heavy opportunistic infection of the bronchi and lungs by the nematode Strongyloides stercoralis which he had presumably acquired while on service abroad. The case illustrates the need, even in non-endemic areas, to suspect opportunistic pulmonary strongyloidiasis when a patient's asthma worsens despite treatment with increasing doses of corticosteroids. Although it is a potentially lethal iatrogenic opportunistic infection, it is amenable to treatment with anthelminthic agents if recognized in time.
Collapse
|
26
|
Miller MJ. Protozoan and helminth parasites - a review of current treatment. PROGRESS IN DRUG RESEARCH. FORTSCHRITTE DER ARZNEIMITTELFORSCHUNG. PROGRES DES RECHERCHES PHARMACEUTIQUES 1976; 20:433-64. [PMID: 796870 DOI: 10.1007/978-3-0348-7094-8_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
27
|
Piller NB. A comparison of the effectiveness of some anti-inflammatory drugs on thermal oedema. BRITISH JOURNAL OF EXPERIMENTAL PATHOLOGY 1975; 56:554-60. [PMID: 1222119 PMCID: PMC2072799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The efficacy of a group of anti-inflammatory drugs with similar modes of action was tested on thermal oedema. Of these, coumarin and sodiumrutin-sulphate were most effective. A combination of these, marketed as Venolot, although still beneficial, was not as effective as either given singly. The other drugs tested--levamisole, Reparil and Venoruton--although also of some benefit in treatment of this oedema, did not approach the overall effectiveness of coumarin of sodium-rutin-sulphate. Both drugs are characterized by a very wide safety margin between the therapeutic and the toxic dose. In addition, they are cheap, easy to obtain and can be taken orally. They work by stimulating phagocytosis, enzyme production and thus proteolysis and a subsequent removal of protein and oedema fluid from the injured tissues.
Collapse
|
28
|
Armstrong D, Chmel H, Singer C, Tapper M, Rosen PP. Non-bacterial infections associated with neoplastic disease. Eur J Cancer 1975; 11suppl:79-94. [PMID: 176031 DOI: 10.1016/b978-0-08-019964-1.50013-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
29
|
Kuberski TT, Gabor EP, Boudreaux D. Disseminated strongyloidiasis. A complication of the immunosuppressed host. West J Med 1975; 122:504-8. [PMID: 1056115 PMCID: PMC1129803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
30
|
Royle G, Fraser-Moodie A, Jones MW. Hyperinfection with Strongyloides stercoralis in Great Britain. Br J Surg 1974; 61:498-500. [PMID: 4835205 DOI: 10.1002/bjs.1800610621] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract
A Jamaican who had been in England for 13 years was successfully treated for hyperinfection with the nematode Strongyloides stercoralis. She presented as an emergency with acute abdominal pain, developed paralytic ileus and responded well to a long course of thiabendazole. A review of the literature revealed reports of 3 other cases of hyperinfection in Great Britain, all of whom had died, 2 afrer laparotomy.
Collapse
|
31
|
Ridley DS. The laboratory diagnosis of tropical diseases with special reference to Britain: a review. J Clin Pathol 1974; 27:435-44. [PMID: 4213454 PMCID: PMC478151 DOI: 10.1136/jcp.27.6.435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|