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Strongyloides and prednisolone

Meysam Sharifdini, Aniseh Hesari, Seif Ali Mahdavi, Akram Alipour, Eshrat Beigom Kia
A case of Strongyloides stercoralis hyperinfection in a patient with dermatomyositis and diabetes mellitus is herein reported. The case was a 60-year-old female admitted due to watery diarrhea and unconsciousness. She had a 10-year history of chronic immunosuppressive therapy including methotrexate and prednisolone for dermatomyositis. Stool parasitological examination revealed numerous rhabditiform larvae of threadworm "S. stercoralis." Larva in stool sample was characterized by sequencing of mitochondrial DNA...
January 2018: Indian Journal of Pathology & Microbiology
M Saraei, B Hosseinbigi, M Shahnazi, B Bijani
PURPOSE: We report a fatal case of Strongyloides hyper-infection as the result of corticosteroid therapy of a patient with myasthenia gravis. CASE PRESENTATION: Our patient was a farmer with a past history of living in an endemic area for Strongyloides stercoralis in Iran. Hyper-infection was diagnosed during the advanced-stage disease by demonstration of enormous number of larvae in the direct smears prepared from both the stool and tracheal secretions. Unfortunately, despite appropriate anti-parasite therapy, the patient died due to respiratory failure...
December 2014: Infection
Özlem Özen Ekmekci, Meryem Tahmaz, Semih Altıparmak, Gülnar Gülaçtı, A Kadir Ergen, A Baki Kumbasar, Sezer Sepetcioğlu, Y Ali Öner
Strongyloides 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...
2013: Türkiye Parazitolojii Dergisi
Jayantee Kalita, Sanjeev K Bhoi, Usha Kant Misra
A 50-year-old villager with chronic inflammatory demyelinating polyradiculoneuropathy developed pain abdomen, diarrhea, and vomiting after 8 weeks of prednisolone (40 mg/day) therapy. After 10 weeks, he developed abdominal distension, leucocytosis, thrombocytopenia, liver dysfunction, coagulopathy, and respiratory failure. Stool examination showed larvae of Strongyloides stercoralis. He died in spite of antibiotics, metronidazole, ivermectin, vasopressor, and artificial ventilation. The patients on corticosteroid therapy are at risk of fatal septicemia due to Strongyloides stercoralis hyperinfection...
August 2012: Pathogens and Global Health
N M S Azira, M Zeehaida
Strongyloides stercoralis is a widespread, soil-transmitted helminth affecting humans. Autoinfection occurs in S. stercoralis infection and this leads to a continuous build-up of worm burden in human host. This may lead to hyperinfection syndrome which has the potential to cause serious life-threatening disease especially in immunocompromised and immunosuppressed patients. Thus, patient with underlying risk factors should be suspicious of having this infection as severe strongyloidiasis carries a high mortality rate if the diagnosis is delayed...
April 2010: Tropical Biomedicine
George Kosmadakis, Christodoulos Georgoulias, Vasileios Filiopoulos, Ioanna Stefanou, Despoina Smirloglou, Spyridon Michail
In this article, we describe the case of a 49-year-old male gypsy on hemodialysis that was referred to our center due to high fever, breathlessness, and productive cough with bloody sputum. Forty-five days before hospitalization, he was treated for vasculitis with prednisolone and intravenous cyclophosphamide. Soon after admission he was resuscitated and intubated after a cardiac arrest. A large worm load of Strongyloides stercoralis larvae was identified in the sputum. The patient was treated with thiopental 25 mg/kgBW/12 h through a Levine tube and died 24 h later...
July 2010: Renal Failure
Mieko Miyazaki, Masahito Tamura, Narutoshi Kabashima, Ryota Serino, Tatsuya Shibata, Tetsu Miyamoto, Yumi Furuno, Tetsuo Nishio, Jiro Ohara, Toshihiro Sakurai, Yutaka Otsuji
Strongyloidiasis, a chronic infection caused by the intestinal parasite Strongyloides stercoralis, is prevalent in the Nansei Islands of Japan. Here, we report our findings on a case of strongyloidiasis complicated with steroid-resistant minimal change nephrotic syndrome in a 69-year-old male resident of Fukuoka Prefecture who had lived in Yakushima, one of the Nansei Islands, until age 15. In October 2006, he developed proteinuria and edema, and was diagnosed with minimal change nephrotic syndrome on the basis of the renal biopsy findings...
August 2010: Clinical and Experimental Nephrology
Eiman M Mokaddas, Shama Shati, Aneesa Abdulla, Narayanan R Nampoori, Jamshaid Iqbal, Prasad M Nair, Tareq Said, Medhat Abdulhalim, Parsotam R Hira
OBJECTIVE: It was the aim of this study to report 3 rare fatal cases of strongyloidiasis in Kuwaiti renal transplant patients. CLINICAL PRESENTATION AND INTERVENTION: All 3 cases received allografts from cadaveric donors of Asian origin, the first 2 from an Indian (transplanted on the same day) and the third from a Bangladeshi. In all 3 cases, Strongyloides stercoralis larvae were first isolated from bronchoalveolar lavage. All 3 patients were on immunosuppressive therapy which included prednisolone, thereby leading to the hyperinfection syndrome...
2009: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Nobuyoshi Takashima, Shogo Yazawa, Akira Ishihara, Sei-ichiro Sugimoto, Kazutaka Shiomi, Kenji Hiromatsu, Masamitsu Nakazato
We report a 49-year-old man who was a human T-cell leukemia virus type 1 (HTLV-1) carrier, born in Okinawa prefecture where both strongyloidiasis and HTLV-1 are endemic. He presented with fever, headache and urinary retention. On the basis of CSF examination and MRI findings, his condition was diagnosed as myelitis. He received methylprednisolone pulse therapy. He was transferred to our hospital due to severe paralytic ileus. Strongyloides stercoralis (S. stercoralis) was found in the duodenal stained tissue of a biopsy specimen...
January 2008: Rinshō Shinkeigaku, Clinical Neurology
Vedat Turhan, Mehmet Coban, Oral Oncül, Saban Cavuşlu
Strongyloidiosis is widely distributed in tropical and subtropical areas but is a rarely reported parasitic infestation in Turkey. Disseminated strongyloidiosis may develop in patients with immunodeficiencies. We report a case of Strongyloides stercoralis infection and Loeffler's syndrome that developed in a patient who had received systemic prednisolone. The patient was a 20 year-old man, born in Hatay, Turkey. The patient presented at our department complaining of abdominal pain and leg pain. After he was admitted for further examination; headache, sore throat and cough developed...
2008: Türkiye Parazitolojii Dergisi
Roongtiva Narata, Suparaporn Wangkaew, Nuntana Kasitanon, Worawit Louthrenoo
Infection, particularly pneumonia, is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). This study was performed to assess the prevalence, causative organisms, and outcomes of community-acquired pneumonia (CAP) in Thai SLE patients, and determine the predicting factors for death. A retrospective chart review of adult SLE patients, age >16 years, seen at the Division of Rheumatology, Chiang Mai University over an 18 year period was carried out. Cases diagnosed with CAP were selected for this study...
May 2007: Southeast Asian Journal of Tropical Medicine and Public Health
Kinjalka Ghosh, Kanjaksha Ghosh
Three apparently immunocompetent patients died in the intensive care unit at Loni Hospital, Ahmednagar, Maharashtra, India, between 2001 and 2006 due to multiorgan failure and Strongyloides stercoralis septicaemia following a short course of corticosteroid (prednisolone) therapy of 6-17 days for peripheral blood eosinophilia associated with urticaria and angioneurotic oedema, bronchospasm, and generalised aches and pains, respectively. None of the patients had any obvious lymphoproliferative disorder, solid tumour or HIV 1+2 infection as an underlying immunosuppressive condition...
November 2007: Transactions of the Royal Society of Tropical Medicine and Hygiene
Kensuke Nakamura, Kohken Ameku, Tetsuya Shiomi, Yoshifumi Matsuura, Kenji Hiromatsu
No abstract text is available yet for this article.
December 10, 2006: Nihon Naika Gakkai Zasshi. the Journal of the Japanese Society of Internal Medicine
Hide Yoshida, Hirahito Endo, Sumiaki Tanaka, Akira Ishikawa, Hirobumi Kondo, Takeshi Nakamura
We present an interesting case of recurrent paralytic ileus due to strongyloidiasis in a woman who was being treated with corticosteroids and immunosuppressants for systemic lupus erythematosus (SLE). She was also a carrier of human T-cell leukemia virus type I. She had a history of strongyloidiasis 8 years earlier. Recurrent episodes of paralytic ileus due to strongyloidiasis occurred during treatment of her SLE with corticosteroids. Ivermectin was given and improved the symptoms. This case shows that symptomatic strongyloidiasis can be induced in immunocompromised hosts by immunosuppressive therapy...
2006: Modern Rheumatology
Uday C Ghoshal, George Alexender, Ujjala Ghoshal, Shweta Tripathi, Narendra Krishnani
Asymptomatic infestation with Strongyloides stercoralis, common in the tropics, may result in potentially fatal hyperinfection during treatment with immunosuppressive drugs used to treat patients with severe ulcerative colitis (UC). Hence, importance of early recognition and treatment of this nematode in patients with UC before starting immunosuppressive drugs can not be overemphasized. We report a 23-yrs old man with UC who presented with acute severe attack. Since his UC did not respond to intravenous hydrocortisone over 6 days, oral cyclosporine was started on 7th day after repeating stool microscopy, which revealed larvae of Strongyloides stercoralis...
March 2006: Indian Journal of Medical Sciences
Ajit Vigg, S Mantri, Vijay Anand P Reddy, V Biyani
Strongyloides stercoralis is a nematode endemic in tropical and subtropical regions. In immunocompetent subjects, pulmonary disease caused by the parasite is unremarkable but the same can be life threatening in immunocompromised subjects. Though described in literature it is rarely seen in Indian subjects. We report a patient with ARDS due to Strongyloides stercoralis complicating non-Hodgkin's lymphoma with neutropenia.
January 2006: Indian Journal of Chest Diseases & Allied Sciences
Bunse Leang, Lut Lynen, Ward Schrooten, Jennifer Hines
Nephrotic syndrome patients on long-term steroids face the risk of having heavy uncomplicated strongyloidiasis or death from its extreme form, the strongyloides hyperinfection. The risk can be minimized if we eradicate the parasite first. We compare a once daily and twice daily albendazole regimen in preventing this potentially fatal complication in 122 patients with nephrotic syndrome.
October 2005: Tropical Doctor
Joshua S Davis, Bart J Currie, Dale A Fisher, Sarah E Huffam, Nicholas M Anstey, Richard N Price, Vicki L Krause, Nathan Zweck, Paul D Lawton, Paul L Snelling, Sid Selva-Nayagam
The population of the Top End of the Northern Territory has a high incidence of several infections of particular significance in the immunosuppressed. The following protocol for evaluation and treatment of patients prior to immunosuppression was developed in order to reduce the incidence of serious opportunistic infections. The infections discussed are Strongyloides stercoralis, tuberculosis, scabies, chronic hepatitis B, melioidosis and other bacterial infections. We recommend that all patients planned to receive more than 0...
2003: Communicable Diseases Intelligence Quarterly Report
Shun Namisato, Kazuhisa Motomura, Shusaku Haranaga, Tetsuo Hirata, Masato Toyama, Takashi Shinzato, Futoshi Higa, Atsushi Saito
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...
August 2004: Internal Medicine
M S Koh, P H Leng, P Eng, J Hwang
INTRODUCTION: Pulmonary haemorrhage is a rare presentation of strongyloides hyperinfection. CLINICAL PICTURE: A 69-year-old female patient with rheumatoid arthritis on methotrexate and prednisolone presented with severe community acquired pneumonia. Intravenous trimethoprim/ sulfamethoxazole (bactrim) and high dose hydrocortisone for Pneumocystis carinii pneumonia were commenced. She developed pulmonary haemorrhage 2 weeks later and bronchoalveolar lavage cytology revealed helminthic larvae identified as strongyloides...
May 2004: Annals of the Academy of Medicine, Singapore
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