Hyperinfection with Strongyloides during treatment of pemphigus vulgaris

Sarubbi, F. A.

doi:10.1001/archderm.123.7.864

Cited by 6 publications

(8 citation statements)

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“…It is advisable to consider the possibility of infection by Strongyloides in patients coming from areas in which such a parasitosis is endemic and who have compatible symptomatology 1,6 . 8,11 Our patient had severe itching associated with widespread nodular lesions, hypereosinophilia, and increased serologic IgE. The asthmatic episode had probably been the body's allergic response to the larval migration along the respiratory tract.…”

Section: Discussionmentioning

confidence: 78%

“…If the immune system is unable to control the helminth's reproduction cycle, a picture of hyperinfection is established with the development of a large number of filariform larvae, sometimes complicated by petechial or purpuric cutaneous lesions due to vessel damage caused by parasitic migration at the level of the dermis and often lethal for the patient. 1 , 3‐8,11 In the disseminated form, the larvae can induce a state of septicemia, sustained by the enteric flora which penetrate the circulation via the damaged mucous surface. 1 , 3‐5,7 , 11 …”

Section: Discussionmentioning

confidence: 99%

“… 1 , 3‐8,11 In the disseminated form, the larvae can induce a state of septicemia, sustained by the enteric flora which penetrate the circulation via the damaged mucous surface. 1 , 3‐5,7 , 11 …”

Section: Discussionmentioning

confidence: 99%

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Prurigo in a patient with intestinal strongyloidiasis

2001

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A 22‐year‐old Senegalese man, who had been in Italy for 2 years, in a good general state of health and with an unremarkable medical history, had been suffering for an unspecified length of time from widespread itching, along with the gradual appearance of numerous keratotic nodular lesions, sometimes interspersed with areas of lichenification in a picture of progressive xerosis ( Fig. 1). During a previous stay in our hospital department, he had suffered a serious attack of asthma, with hypereosinophilia (19%) and an increase in serologic immunoglobulin E (IgE) (2000 IU/mL). 1 Clinical view of the lesions on the left leg A histologic examination of a lesion removed from the patient's back revealed the presence of slight acanthosis and an inflammatory infiltrate in the surface and middle dermis, mainly consisting of lymphocytes and a few eosinophils ( Fig. 2). 2 Histologic view of a lesion (hematoxylin and eosin, × 250) A parasitologic examination of the feces revealed the cause of the clinical picture, and led to the identification of Strongyloides stercoralis ( Fig. 3). The patient was subjected to a short cycle of treatment with albendazole, 400 mg/day for three consecutive days. 3 Parasite isolated from the feces (direct examination, × 100) The patient was kept under observation for the next 6 months, and his clinical picture and symptomatology slowly but gradually improved. Examination of the feces gave a negative result.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Prurigo in a patient with intestinal strongyloidiasis

2001

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“…Blood cultures from patients with hyperinfection have grown Escherichia coli (3,97), Klebsiella pneumoniae (12), Proteus mirabilis (12,121), Pseudomonas (61), Enterococcus faecalis (63), coagulase-negative staphylococci (101), Streptococcus bovis (63), and Streptococcus pneumoniae (12). Polymicrobial infections can also occur (63).…”

Section: Other Manifestationsmentioning

confidence: 99%

“…Polymicrobial infections can also occur (63). In addition to enteric gram-negative rods spreading systemically in this fashion, patients on immunosuppressive regimens may also develop systemic Candida infections by presumably similar mechanisms (86,94,101).…”

Section: Other Manifestationsmentioning

confidence: 99%

Strongyloides stercoralisin the Immunocompromised Population

2004

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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

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