Strongyloidiasis: Epidemiology, Clinical Manifestations and New Methods for Diagnosis and Treatment

Saitô, Atsushi

doi:10.1007/bf02348752

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…Strongyloidiasis is widely distributed in tropical and subtropical areas (1,11). Disseminated strongyloidiasis frequently develops in patients with immunodeficiencies caused by poor nutrition, drug therapy (including steroid therapy) for autoimmune diseases, chronic alcoholism, advanced age, diabetes mellitus, collagen disease, a post-surgery status, or a high titer of HTLV-1 (11,12).…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported a low body temperature, coughing, laryngismus paralytics, and blood-stained sputum as possible symptoms (7,8). In the absence of early diagnosis and treatment, the prognosis of disseminated strongyloidiasis is extremely poor (6,9,11,13). Some studies have reported that a patient's prognosis is related to the severity of their underlying condition (9).…”

Section: Discussionmentioning

confidence: 99%

“…Sometimes lung abscess is also seen (9,12). These chest imaging findings and many of the respiratory symptoms in patients with disseminated strongyloidiasis are thought to be caused by one of the following three mechanisms (11,14,17). First, filariform larvae multiply through the augmentation of autoinfection and infiltrate the intestinal mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…At this stage, chest X-rays may reveal various patterns, such as alveolar and interstitial shadow patterns, lobar pneumonia, etc (8,9,17). Finally, bacterial pneumonia, a complication of pulmonary strongyloidiasis, might be caused by the "piggyback" transport of bacteria from the intestines (11).…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Strongyloidiasis in a Patient Receiving Prednisolone Therapy

Namisato

Motomura²,

Haranaga

et al. 2004

Intern. Med.

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Strongyloidiasis is widely distributed in tropical and subtropical areas. Disseminated strongyloidiasis may develop in patients with immunodeficiencies. In the absence of early diagnosis and treatment, the prognosis of disseminated strongyloidiasis is extremely poor. We report a case of pulmonary strongyloidiasis that was successfully treated. The patient was an 83-year-old woman who had been receiving long-term oral prednisolone therapy for uveitis. The patient visited our emergency department complaining of breathing difficulties and diarrhea. A chest X-ray revealed a diffuse enhancement of interstitial shadows. A bronchoalveolar lavage (BAL) was performed, and both Gram staining and Grocott's staining revealed the presence of multiple filariform larvae of Strongyloides stercoralis in the bronchoalveolar lavage fluid (BALF). A stool examination performed at the same time also yielded S. stercoralis. The patient was diagnosed as having pulmonary strongyloidiasis and was treated with thiabendazole and ivermectin, in addition to antimicrobial agents; her respiratory symptoms and diarrhea improved, and S. stercoralis was not detected in subsequent follow-up examinations thereafter. In endemic areas of S. stercoralis, pulmonary strongyloidiasis should be considered as part of a differential diagnosis if chest imaging findings like alveolar and interstitial shadow patterns or lobar pneumonia are seen in patients with immunodeficiencies. (Internal Medicine 43: 731-736, 2004)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pulmonary Strongyloidiasis in a Patient Receiving Prednisolone Therapy

Namisato

Motomura²,

Haranaga

et al. 2004

Intern. Med.

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“…Strongyloides stercoralis (S. stercoralis) enfeksiyonlarına tropikal iklim kuşağında endemik olarak rastlanmaktadır (1). Bu enfeksiyon Türkiye gibi ılıman ülkelerde ise genellikle bağışıklığı baskı-lanmış hastalarda sporadik olgular şeklinde görülmektedir.…”

Section: Introductionunclassified

Strongyloidosis Caused Loeffler's Syndrome in an Immunosuppressed Patient Who Uses Cronic Steroid

Ekmekci¹,

Tahmaz²,

Altıparmak³

et al. 2013

TurkiyeParazitolDerg

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ÖZETStrongyloides strecoralis tüm dünyada on milyonlarca insanı enfekte eden bir insan barsak nematodudur. Ülkemizde nadiren görülmektedir. İmmün yetmezlikli hastalarda dissemine strongyloidiosis enfeksiyonu gelişebilir. S. stercoralis hiperenfeksiyonu sıklıkla enterik organizmalar ile oluşan menenjit veya sepsise eşlik eder. Glukokortikoid tedavisi hiperenfeksiyonu tetikleyen en sık durumlardan birisidir fakat hematolojik maligniteler, malnutrisyon ve AİDS ile ilişkili vakalar bildirilmektedir. İvermektin gibi antihelmintik ajanlar hiperenfeksiyon sendromunu tedavide başarı ile kullanılmaktadır. Biz burada uzun süredir steroid kullanan ve akciğerde kitle öntanısı ile tetkik edilen 82 yaşındaki bir hastada saptanan S. stercoralis enfeksiyonu ve Loeffler sendromlu bir olguyu sunuyoruz. Hasta göğüs hastalıkları kliniğinde sağ akciğer üst lobda kitle görüntüsü nedeniyle tetkik edilirken, karın ağrısı, diare ve kaşıntı şikayetlerinin olması üzerine tarafımıza yönlendirilmişti. Periferik yaymasında %43 eozinofili görüldü. Gaitanın parazitolojik incelemesinde Strongyloides stercoralis larvaları görüldü. Hastada parazitoz ve loeffler sendromu olabileceği düşünüldü. Albendazol tedavisi sonrası hastanın şikayetlerinde önemli ölçüde gerileme izlendi. (Turkiye Parazitol Derg 2013; 37: 55-7) Anahtar Sözcükler: Strongyloides stercoralis, kronik diyare, Loeffler sendromu Geliş Tarihi: 11.01.2012Kabul Tarihi: 12.01.2013 ABSTRACTStrongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. It is a rarely reported parasitic infestation in Turkey. Disseminated strongyloidiosis may develop in patients with immunodeficiencies. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment is one of the conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelminthic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome. We report a case of Strongiloides stercoralis infection and Loeffler syndrome that developed in a patient who had systemıc prednisolone. Thepatient in the pulmonary disease department clinic was examined because of right lung upper lobe mass image, and referred to us with complaints of abdominal pain, diarrhea and pruritus. Peripheral smear showed 43% eosinophilia. Parasitological examination of faeces showed larvae of Strongyloides stercoralis. Parasitosis and Loeffler's syndrome was considered in the patient. Thepatient's complaints declined significantly after treatment with albendazole. (Turkiye Parazitol Derg 2013; 37: 55-7)

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