Strongyloides and prednisolone

Human T-lymphotropic virus-1 (HTLV-I) is an enveloped, single-stranded RNA virus of the Retroviridae family. The virus causes two well-recognized disease associations: adult T-cell leukemia/lymphoma (ATL) and HTLV-I-associated myelopathy (HAM), also known as tropical spastic paraparesis (TSP). We report a case of HTLV-1-induced adult T-cell lymphoma/leukemia in a 45-year-old female who presented with complaints of swelling on the right side of her neck and rash on her upper and lower extremities and abdomen...

People living in areas endemic for strongyloidiasis are at risk of latent Strongyloides stercoralis infection. Corticosteroid therapy is a well-established risk factor for life-threatening hyperinfection syndrome and disseminated disease owing to suppression of the immune system. There are limited data available on the efficacy and cost of providing oral ivermectin prophylaxis to all patients receiving high-dose corticosteroids for strongyloidiasis in endemic areas. We thus conducted this retrospective cohort study at Khon Kaen University's Srinagarind Hospital from 2015 to 2019...

BACKGROUND: Strongyloides stercoralis (S. stercoralis) , a unique parasite, can cause mortal disease even years after the exposure. Iatrogenic use of steroids can complicate asymptomatic infections to a life-threatening hyperinfection and/or disseminated infection. Data regarding seroprevalence of strongyloidiasis remains scarce and this knowledge gap needs due attention in many endemic countries including India. AIM: The present study is aimed at assessing the seroprevalence of Strongyloides infection and the need for routine screening among individuals receiving steroid therapy...

BACKGROUND: Strongyloidiasis is a soil-transmitted helminthiasis mainly caused by Strongyloides stercoralis. It is endemic to the tropics and subtropics. Sri Lanka has a 0-1.6% prevalence rate. S. stercoralis infection was identified in a 33-year-old Sri Lankan male patient treated with corticosteroids for borderline lepromatous leprosy with adrenocortical dysfunction. CASE PRESENTATION: In March 2020, a 33-year-old Sri Lankan (Sinhalese) male patient presented with watery diarrhea, lower abdominal pain, and post-prandial abdominal fullness...

Strongyloidiasis, an intestinal parasitic infection caused by Strongyloides stercoralis, rarely occurs in Japan. When treated with immunosuppressive drugs, two potentially lethal conditions, hyperinfection and dissemination, may develop in asymptomatic carriers of this parasite. We report development of strongyloidiasis during treatment of polymyositis with glucocorticoids plus rituximab. A 44 year-old woman had been diagnosed with anti-signal recognition particle antibody-positive polymyositis with interstitial pneumonia 6 years previously, for which she had recently been receiving prednisolone at 5 mg/day and rituximab at 375 mg/m2 twice every 3 months...

Patient 1 was a 59-year-old male originally from Vietnam with end-stage renal disease secondary to IgA nephropathy, with hypertension and T2DM. He underwent cadaveric renal transplantation with basiliximab and methylprednisolone induction followed by maintenance tacrolimus, mycophenolate mofetil and tapering prednisolone. He was treated for CMV reactivation and developed an acneiform folliculitis during the post-transplant course which was otherwise uncomplicated. He presented three months later with abdominal pain, constipation and vomiting...

We report a case of a fatal Strongyloides stercoralis hyperinfection syndrome (SHS) in a migrant from Kenya, who had been living in Germany for three decades. A short-course oral steroid treatment for Chronic Obstructive Pulmonary Disease (COPD) exacerbation had been administered four weeks prior to the presentation. The initial clinical and radiological findings suggested a mechanical small bowel obstruction as a cause of ileus. Our case highlights the importance of maintaining a high index of suspicion for strongyloidiasis in patients from endemic areas even years after they left the country of origin...

Strongyloides venezuelensis is a model to study human strongyloidiasis, which infects wild rodents and shares common antigenic epitopes with Strongyloides stercoralis. This study aimed to evaluate parasitological and immunological parameters of prednisolone immunosuppression protocols in rats (Rattus novergicus) infected with S. venezuelensis. Rats were divided into six groups (n=36): untreated and uninfected (-) or infected (+); oral treatment and uninfected (o-) or infected (o+); subcutaneous treatment and uninfected (sc-) or infected (sc+)...

Introduction: Strongyloidiasis is a neglected tropical disease with global prevalence. Under some cases of immune suppression (especially with corticosteroid administration), the nematode involved disseminates, leading to an amplified, possibly lethal hyper-infection syndrome. Case presentation: A 56-year-old Nepalese man presenting with chief complaints of nausea, vomiting, joint pain and abdominal cramps was admitted to Sumeru Hospital. His past history revealed: chronic obstructive pulmonary disease (COPD), systemic hypertension and previously treated pulmonary tuberculosis...

Glucocorticoid treatment increases the risk of opportunistic infection. Infections that can arise during glucocorticoid use, and for which preventative measures can be taken, include reactivation of latent tuberculosis and hepatitis B, pneumococcal and Pneumocystis jiroveci pneumonia, influenza, herpes zoster and Strongyloides stercoralis hyperinfection syndrome. The risk of such infections depends upon the duration of glucocorticoid use and dosage, as well as comorbidity and comedication. It is important to enquire about vaccinations, travel, exposure and previous infections when taking a case history...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...