Cases reported "Superinfection"

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1/12. Hyperinfection syndrome in strongyloidiasis: report of two cases.

    Hyperinfection in strongyloidiasis has been associated with corticosteroid treatment. Other immunodepressive conditions also seem to facilitate the state of hyperinfection. The etiologic diagnosis of this parasitosis can be difficult to reach and a positive urine microscopy is unusual. We report two patients under corticosteroid therapy with disseminated strongyloidiasis; both had eosinophilia. The first patient, followed for 8 years for autoimmune hemolytic anemia, recently developed abdominal symptoms. A colonoscopy was performed 1 month before admission and the biopsy was thought to show nonspecific changes. At admission, few larvae of strongyloides stercoralis were disclosed by urine microscopy, and a review of the colonic biopsy uncovered a few larvae of Strongyloides. The patient received anti-helmintic therapy with a dramatic improvement. The second patient, under treatment for lupus erythematosus for 3 years, was admitted with pulmonary symptoms and during admission developed massive gastrointestinal bleeding. Disseminated strongyloidiasis was discovered only at autopsy. The low suspicion index for strongyloidiasis resulted in delaying the etiologic diagnosis in one patient and in failing to diagnose the disease in the other. The morphologic features of the parasite in the two cases are presented with emphasis on the difficulties of recognizing the larvae in the intestinal biopsy.
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ranking = 1
keywords = stercoralis
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2/12. Strongyloides hyperinfection in a patient with sarcoidosis.

    A 51-year-old-woman presented with chronic eosinophilia, a diffuse interstitial lung pattern on CT and splenomegaly with hypodense lesions. A diagnosis of sarcoidosis was determined from a lung biopsy. Hyperinfection with strongyloides following treatment with systemic steroids explains the presence of eosinophilia and splenic involvement.
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ranking = 1.5952084047797
keywords = strongyloides
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3/12. Strongyloides hyper-infection: a case for awareness.

    In patients receiving immunosuppressive therapies, strongyloides stercoralis can cause a life-threatening septic shock, with multi-organ failure and infestation. Strongyloides hyper-infection should be considered in any immunosuppressed patient who has been exposed to the parasite, even if it is many years since that exposure occurred. Delayed eosinophilia may be a feature and treatment with high doses of anthelmintics may be required. An interesting case of S. stercoralis hyper-infection was recently observed at the Royal Darwin Hospital in tropical, northern australia. The patient was an 18-year-old female with lupus glomerulonephritis, who was receiving immunosuppression in the form of corticosteroids and pulse cyclophosphamide. The characteristics and intensive-care management of this case, including the use of granulocyte-colony stimulating factor and high-dose ivermectin, are described. The patient, who survived, appears to represent the first reported case of S. stercoralis hyper-infection with suspected myocarditis.
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ranking = 3
keywords = stercoralis
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4/12. An unusual cause of pulmonary haemorrhage in a patient with rheumatoid arthritis.

    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. TREATMENT AND OUTCOME: Despite treatment with ivermectin and albendazole with rapid tailing down of hydrocortisone, she succumbed to her illness. CONCLUSIONS: Strongyloides hyperinfection should be considered in an immunocompromised patient on high dose corticosteroid presenting with pulmonary haemorrhage. prognosis remains dismal as supported by our case report and current literature.
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ranking = 3.1904168095593
keywords = strongyloides
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5/12. death caused by strongyloides hyperinfection in a leprosy patient on treatment for a type II leprosy reaction.

    strongyloides stercoralis is present worldwide and can cause hyperinfection in patients on long-term immunosuppressive doses of steroids, as is sometimes the case for patients treated for leprosy reactions. Strongyloides hyperinfection can present with ileus, as is discussed in this case report. physicians, including surgeons, should be aware of this entity in order to avoid an unnecessary laparotomy. Though patients may survive if diagnosed at an early stage, strongyloides hyperinfection syndrome has a mortality rate of 87% and prevention is therefore of utmost importance.
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ranking = 8.9760420238983
keywords = strongyloides, stercoralis
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6/12. A case of fatal hyperinfective strongyloidiasis with discovery of autoinfective filariform larvae in sputum.

    The autoinfective filariform larva of strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 /- 21.2 microm in length and 11 /- 0.6 microm in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in korea.
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ranking = 3
keywords = stercoralis
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7/12. Fatal stongyloides hyperinfection in heart transplantation.

    S stercoralis is an intestinal parasite that normally causes a chronic, low-grade, mostly asymptomatic infection. Hyperinfection syndrome and dissemination, with secondary sepsis, may occur in immunosuppressed patients, especially those on corticosteroid therapy. We present a case of fatal strongyloidiasis occurring in a patient 1 month after orthotopic heart transplantation (OHT). We assess the diagnostic challenges in these patients where pulmonary and gastrointestinal symptoms predominate as presenting clinical manifestations. We also investigate the role of screening and prophylactic anti-helmintic therapy in patients at high risk of harboring the occult intestinal infection.
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ranking = 1
keywords = stercoralis
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8/12. Strongyloides hyperinfection in two patients with lymphoma, purulent meningitis, and sepsis.

    strongyloides stercoralis hyperinfection syndrome is a rare complication of strongyloidiasis that occurs in immunosuppressed patients. It is caused by increasing autoinfection of the host by the nematode, leading to serious superimposed enterobacterial sepsis. Once established, it has a high fatality rate. Two cases are reported of Strongyloides hyperinfection in patients with lymphoma who presented with purulent meningitis. Both were receiving combination chemotherapy that included high-dose corticosteroids, and neither was granulocytopenic at infectious onset. The patients had respiratory insufficiency that required mechanical ventilation and serious septic episodes. Both were treated with thiabendazole, and one survived with clearance of the larvae. These cases illustrate the possibility of strongyloidiasis hyperinfection as an underlying diagnosis of purulent meningitis and serious septic episodes in lymphomatous patients. It may occur even without granulocytopenia.
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ranking = 1
keywords = stercoralis
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9/12. 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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ranking = 7
keywords = stercoralis
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10/12. Disseminated strongyloidiasis in a diabetic patient.

    A case of disseminated strongyloidiasis in an Indian diabetic patient who was not receiving any immunosuppressive therapy, is reported. strongyloides stercoralis was detected in peritoneal fluid, stools and blood. To our knowledge this represents the first such case to be reported in the English literature. The need for both clinicians and microbiology laboratories to be on the alert for this parasite in patients who are compromised either because of underlying disease or therapy with immunosuppressive drugs, is emphasised.
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ranking = 1
keywords = stercoralis
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