Severe strongyloidiasis in corticosteroid-treated patients: Case series and literature review

Fardet, L.; Généreau, T; Poirot, Jean-Louis; Guidet, Bertrand; Kettaneh, A.; Cabané, J.

doi:10.1016/j.jinf.2006.01.016

Cited by 154 publications

(125 citation statements)

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“…[14][15][16][17][18][19][20] sometimes septic shock, disseminated intravascular coagulation, renal and respiratory failure. 30,31 Disseminated infection refers to the migration of larvae to organs beyond the range of pulmonary auto infective cycle, but does not imply a greater severity of disease. 16 At the admission of our patient to the emergency department, the clinical picture was compatible with septic shock, confirmed by the autopsy findings and the positive blood culture for E. coli, one of the most frequent bacteria associated with S. stercoralis hyperinfection.…”

Section: Discussionmentioning

confidence: 99%

Strongyloides stercoralis hyperinfection - a dreaded but still missed diagnosis

Crenitte¹,

Campos²,

Felipe-Silva³

2012

ACR

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Strongyloides stercoralis (S. stercoralis), an intestinal nematode, is endemic in tropical and subtropical regions, being less prevalent in temperate climates. The number of infected persons worldwide ranges between 10 million and 100 million people. In Brazil the reported prevalence is 13%. Chronic infection may be asymptomatic or accompanied by gastrointestinal and respiratory symptoms. Under immunosuppressive conditions, the infection assumes serious proportions frequently accompanied by septic shock, disseminated intravascular coagulopathy and respiratory distress syndrome. The authors report a case of a 50-year-old female patient who was a chronic user of glucocorticoids and had been seeking medical attention for two months because of continuous gastrointestinal symptoms. She was admitted to the emergency room with clinical signs of septic shock and died after four days despite an adequate antibiotic regimen, vasopressor drugs, and ventilatory support. The autopsy revealed the unsuspected finding of S. stercoralis hyperinfection and septicemia.

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Section: Discussionmentioning

confidence: 99%

Strongyloides stercoralis hyperinfection - a dreaded but still missed diagnosis

Crenitte¹,

Campos²,

Felipe-Silva³

2012

ACR

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“…Eosinopenia, or at least absence of eosinophilia, is associated with most conditions in which immunodeficiency leads to S. stercoralis hyperinfection and consequently to high lethality 6,13 . On the other hand, patients with strongyloidiasis and hyper eosinophilia appear to survive longer 6,20 and may have few symptoms in spite of immune suppression 25 .…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, patients with strongyloidiasis and hyper eosinophilia appear to survive longer 6,20 and may have few symptoms in spite of immune suppression 25 . Our case is unusual in the fact that hyper-eosinophilia has been constant throughout eight months of observation.…”

Section: Discussionmentioning

confidence: 99%

“…Relevant causes of immune deficiencies associated with hyperinfection by S. stercoralis are malignancies such as lymphoma 7,16 , leukaemia 14 , immunosuppression with drugs, among which steroids are of major importance 14,15,16 , organ and tissue transplants 5,19 . In a high percentage of all these situations, treatment with immunosuppressive drugs, particularly steroids, seems to be important 6 . Steroids are known to suppress eosinophilia and lymphocyte activation 4,14 .…”

Section: Introductionmentioning

confidence: 99%

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Hyperinfection by Strongyloides stercoralis probably associated with Rituximab in a patient with mantle cell lymphoma and hyper eosinophilia

Incani¹,

Hernández

González³

2010

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThe first report to our knowledge, of hyperinfection by Strongyloides stercoralis (HS) and hypereosinophilia, associated to immune suppression by Rituximab (the only drug received for the last one year and 10 months), in a patient with mantle-cell lymphoma (MCL), is presented. The patient has a 3-year history of MCL, and developed two accesses of HS during 2008, including meningitis, pneumonia and presence of larvae of S. stercoralis in the lungs. We had a unique chance to look at cytotoxicity of filariform larvae in the expectoration after Ivermectin treatment, showing immobilization and death of larvae, associated with eosinophils attached to the cuticle of the parasite.

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“…Fardet y cols., observaron una mayor frecuencia de parasitados por Strongyloides stercoralis en individuos alcohólicos, diabéticos, portadores del virus linfotrópico humano de células T del tipo 1 (HTLV-1), pacientes receptores de trasplantes o en corticoterapia 13 . Otros estudios realizados identificaron la ocurrencia de estrongiloidiasis en pacientes infectados por el virus de la inmunodeficiencia humana (VIH) y con neoplasias hematológicas, con prevalencias que variaban entre 5,5 a 12,0% 14,15 y 8,3 a 23% 16,17 , respectivamente.…”

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