Strongyloides stercoralis hyperinfection after corticosteroid therapy: a report of two cases

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Two cases of Strongyloides stercoralis hyperinfection are described. Both patients were expatriates from the Indian subcontinent, and reported the use of corticosteroids. The first patient presented with severe pulmonary disease that necessitated respiratory support, followed by acute abdomen and intestinal obstruction and he succumbed to these diseases. The second patient also presented with acute pulmonary disease, which responded to antihelmintic treatment and supportive care; however, he died later due to his primary disease. The clinical features of S stercoralis hyperinfection are nonspecific; therefore, a high index of suspicion is required for early diagnosis and to start appropriate therapy. Because of the seriousness of the disease and the associated high mortality we suggest screening for S stercoralis in patients from endemic areas who will be taking immunosuppressive therapy.

Related collections

Most cited references 20

Record: found
Abstract: found
Article: not found

Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease.

R M Genta (2016)

Opportunistic disseminated strongyloidiasis is an important cause of morbidity and mortality in immunocompromised patients. However, the worldwide prevalence of Strongyloides stercoralis is difficult to determine because adequate data are lacking. In this paper more than 100 epidemiologic studies reporting on the prevalence of S. stercoralis among various populations on five continents are critically reviewed. Analysis of this information indicates that the following groups of people may be at risk: residents of an emigrants from any developing country and southern, eastern, and central Europe; travelers and veterans returning from endemic areas; natives and residents of the Appalachian region in the United States and local endemic areas in other countries; and institutionalized persons. Because disseminated infections may be prevented by early treatment of asymptomatic chronic infections, screening programs are recommended to detect latent S. stercoralis infection before the initiation of chemotherapy or immunosuppression in patients at risk. Serologic tests are sensitive and specific but are not yet widely available. Thus strong suspicion based on clinical and epidemiologic clues in conjunction with repeated stool examinations remains the best way to rule out S. stercoralis infection in these groups.

0 comments Cited 58 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Patterns of detection of Strongyloides stercoralis in stool specimens: implications for diagnosis and clinical trials.

Natalia Rocha, Allan Albuquerque, D Addiss … (1996)

Reported efficacies of drugs used to treat Strongyloides stercoralis infection vary widely. Because diagnostic methods are insensitive, therapeutic trials generally require multiple negative posttreatment stool specimens as evidence of drug efficacy. However, only a single positive stool specimen is usually required for study enrollment. To determine the reproducibility of detection of S. stercoralis larvae in the stool, 108 asymptomatic infected men submitted 25 g of fresh stool once a week for eight consecutive weeks for examination by the Baermann technique. During the 8-week study, 239 (27.7%) of 864 stool specimens were positive for S. stercoralis. Rates of detection of larvae in the stool specimens ranged from eight of eight specimens in 3 (2.8%) men to none of eight specimens in 36 (33.3%) men. Of 43 men for whom S. stercoralis was detected in at least two of the first four stool specimens, only 1 (2.3%) man tested negative on all of the next four specimens. In comparison, of 29 men who had detectable larvae in only one of the first four specimens, 22 (75.9%) tested negative on all of the next four samples. Thus, if these 29 men had been enrolled in a therapeutic trial between the first and second sets of four specimens, the efficacy of a drug with no activity against this parasite would have been estimated to be 76%. These data suggest that patterns of S. stercoralis detection vary widely among infected persons and that intermittent larval shedding can lead to inflated estimates of drug efficacy. Before a patient is entered in a clinical trial of drug efficacy, four consecutive stool specimens should be examined for S. stercoralis; only persons with two or more positive specimens should be enrolled.

0 comments Cited 43 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Fluctuations of larval excretion in Strongyloides stercoralis infection.

N Morakote, P Uparanukraw, S Phongsri (1999)

Follow-up stool examinations were carried out on two groups of the subjects who were screened negative (group 1) or positive (group 2) for Strongyloides stercoralis by the agar plate culture. This technique could detect S. stercoralis larvae in 87.5-96.4% of the subjects in group 2 and 0-5.9% of the subjects in group 1 on various days of the eight-week and four-week follow-up periods, respectively. The detection rate on each day of examination was not statistically different from that on the first day in both groups. Quantitative measurement of S. stercoralis larvae excreted in the feces of the subjects in group 2 by the standard direct smear method of Beaver and others revealed slight to marked fluctuations of the larval output in individual subjects. From the results of both stool examination methods, it could be implied that 52% of S. stercoralis-infected individuals had low-level infection.

0 comments Cited 34 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Ann Saudi Med

Journal ID (publisher-id): ASM

Title: Annals of Saudi Medicine

Publisher: Medknow Publications (India )

ISSN (Print): 0256-4947

ISSN (Electronic): 0975-4466

Publication date (Print): Sep-Oct 2009

Volume: 29

Issue: 5

Pages: 397-401

Affiliations

[a ]From the Department of Medicine, Hamad Medical Corporation, Doha, Qatar

[b ]From the Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar

Author notes

Correspondence: Hussam Alsoub, MD · Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar · T: +974-439-2678 F: +974-439-2273 · hussamalsoub@ 123456yahoo.com · Accepted for publication March 2009

Article

Publisher ID: ASM-29-397

DOI: 10.4103/0256-4947.55172

PMC ID: 2860402

PubMed ID: 19700900

SO-VID: ae744e67-4e8e-4437-a9a8-66cb48cd65a4

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Strongyloides stercoralis hyperinfection after corticosteroid therapy: a report of two cases

Read this article at

Abstract

Related collections

Negative Pressure Wound Therapy Journal

Most cited references 20

Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease.

Patterns of detection of Strongyloides stercoralis in stool specimens: implications for diagnosis and clinical trials.

Fluctuations of larval excretion in Strongyloides stercoralis infection.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 595

Cited by 8

Most referenced authors 228