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1/4. Exacerbation of chronic obstructive pulmonary disease due to hyperinfection with strongyloides stercoralis.

    Pulmonary infection due to the filariform larvae of Strongloides stercoralis may occur in immunocompromised patients residing in endemic areas of the United States. Such infection usually presents as dyspnea with a cough that sometimes results in bloody sputum. Although the chest roentgenogram often reveals a patchy bilateral alveolar infiltrate, acute respiratory distress is unusual. We report a patient who experienced severe exacerbation of his underlying obstructive lung disease that was associated with chest infiltrates and recovery of S stercoralis from his sputum. Although initial improvement was accomplished with Thiobendazole treatment, a re-exacerbation occurred when antiparasitic therapy was completed. The persistence of his infection is correlated to factors that are commonly employed in the treatment of COPD but may be overlooked as predisposing causes of hyperinfection with S stercoralis.
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keywords = stercoralis
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2/4. Pulmonary hyperinfection syndrome with strongyloides stercoralis.

    A 65-year-old man with steroid-dependent chronic airflow obstruction presented with progressive dyspnea and weight loss. travel history included a military tour in southeast asia. A chest roentgenogram revealed hyperexpanded lung fields with diffusely increased interstitial markings. The Papanicolaou stain of expectorated sputum demonstrated the rhabditiform larvae of strongyloides stercoralis. Endemic areas of infection include the southeastern united states, puerto rico, central america, the Pacific basin, and central africa. In recent immigrant groups and veterans of the vietnam conflict, rates of infection are as high as 6 percent. The hyperinfection syndrome occurs in immunocompromised hosts and is associated with glucocorticoid steroid therapy. This allows massive proliferation of larval forms. Clinical clues include an appropriate travel history (even in the remote past), gastrointestinal symptoms, cutaneous symptoms, eosinophilia, or thrombocytosis. Our patient demonstrated a classic presentation of the hyperinfection syndrome, and the condition responded well to thiabendazole.
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ranking = 0.71428571428571
keywords = stercoralis
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3/4. Restrictive pulmonary disease due to interlobular septal fibrosis associated with disseminated infection by strongyloides stercoralis.

    strongyloidiasis is caused by the nematode strongyloides stercoralis. The parasite has a unique life cycle that enables it to cause a hyperinfection syndrome in which pulmonary involvement is characteristic. We describe the case of a 68-yr-old Hispanic male from puerto rico with disseminated strongyloidiasis who developed intense granulomatous reaction in the lung associated with interlobular septal fibrosis. Granulomatous lung disease leading to fibrosis within the lung has been well demonstrated in schistosomiasis, another parasitic disease. This case represents the first report, as far as we are aware, of fibrosis within the lung and restrictive pulmonary disease in association with strongyloides stercoralis.
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ranking = 0.85714285714286
keywords = stercoralis
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4/4. Disseminated strongyloidiasis with cutaneous manifestations in an immunocompromised host.

    Recognition of the characteristic cutaneous eruption of disseminated strongyloidiasis can be crucial for early diagnosis and treatment of this potentially fatal infestation. We describe a corticosteroid-dependent elderly man who had a purpuric eruption. Filariform larvae of strongyloides stercoralis were found in dermal granulomas and also in the sputum.
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ranking = 0.14285714285714
keywords = stercoralis
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