A Case of Fatal Strongyloidiasis in a Patient with Chronic Lymphocytic Leukemia and Molecular Characterization of the Isolate

Kia, Eshrat Beigom; Rahimi, Hamid Reza; Mirhendi, Hossein; Nilforoushan, Mohammad Reza; Talebi, Ardeshir; Zahabiun, Farzaneh; Kazemzadeh, Hamid; Meamar, Ahmad Reza

doi:10.3347/kjp.2008.46.4.261

Cited by 24 publications

(24 citation statements)

References 10 publications

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“…This can lead to disseminated infection in which the parasite is found in remote sites including the skin, cardiovascular and central nervous systems (18,19). Hyperinfection and dissemination carry significant morbidity and mortality with fatality rates reaching 85% (5,6,19). Hyperinfection and dissemination have been reported in patients with diabetes, hematologic malignancies, malnutrition, hypogammaglobulinemia and with the use of immunosuppressive drugs in autoimmune disease and organ transplantation (1,7,19).…”

Section: Discussionmentioning

confidence: 99%

Single Donor-Derived Strongyloidiasis in Three Solid Organ Transplant Recipients: Case Series and Review of the Literature

Ravin

Hasan

et al. 2014

American Journal of Transplantation

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y Both authors have contributed equally to this work. Donor-derived Strongyloides stercoralis infections in transplant recipients are a rare but recognized complication. In this case series, we report donor-derived allograft transmission of Strongyloides in three solid organ transplant recipients. Following detection of infection in heart and kidney-pancreas recipients at two different transplant centers, a third recipient from the same donor was identified and diagnosed.S. stercoralis larvae were detected in duodenal aspirates, bronchial washings, cerebrospinal fluid, urine and stool specimens. Treatment with ivermectin and albendazole was successful in two of the three patients identified. The Centers for Disease Control and Prevention was contacted and performed an epidemiologic investigation. Donor serology was strongly positive for S. stercoralis antibodies on retrospective testing while all pretransplant recipient serum was negative. There should be a high index of suspicion for parasitic infection in transplant recipients and donors from endemic regions of the world. This case series underscores the need for expanded transplant screening protocols for Strongyloides. Positive serologic or stool tests should prompt early treatment or prophylaxis in donors and recipients as well as timely notification of organ procurement organizations and transplant centers.

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Section: Discussionmentioning

confidence: 99%

Single Donor-Derived Strongyloidiasis in Three Solid Organ Transplant Recipients: Case Series and Review of the Literature

Ravin

Hasan

et al. 2014

American Journal of Transplantation

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“…Immunologic techniques, such as enzyme-linked immunosorbent assay and immunoblots, and molecular methods based on gene amplification can also be useful in diagnosis. 104 Seventy-five percent of the 106 patients tested positive in stool specimens, while 24, 8, 4 and 2% were positive in sputum, urine, vomit and duodenal drainage specimens, respectively. Approximately 1% of the patients had positive results for strongyloidiasis in gastric juices, hydrocele, cerebrospinal fluid, scrotal hydrocele fluid, and pericardial effusions.…”

Section: Resultsmentioning

confidence: 99%

Strongyloidiasis: An Emerging Infectious Disease in China

Wang

Xu²,

Zhou³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Since the first case of strongyloidiasis reported in China in 1973, there have been 330 confirmed cases as of 2011. The present study conducted a meta-analysis on 106 cases for which detailed information on clinical symptoms, diagnosis, and outcome was available. Most (63%) cases were from the past decade. Immunocompromised patients and those given cortical hormones accounted for 68% of the cases, and case-fatality rate was 38%. General clinical symptoms included abdominal pain (53%), diarrhea (46%), fever (40%), and vomiting (39%). The parasite positivity rate in feces, sputum, and urine by microscopic diagnosis was 75%, 24%, and 8%, respectively, and gastrointestinal endoscopy or other biopsy detection rates were 17%. A lack of specific clinical manifestations makes early diagnosis and correct treatment difficult. Strongyloidiasis is an emerging disease in China, and public and clinical awareness needs to be raised to improve prevention and control.

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“…(14) Numerous reports have documented the association of immunosuppressive therapy and steroids as a primary cause of fatal Strongyloides hyperinfection in cancer patients. (18)(19)(20) Serodiagnosis has been reported to provide useful indirect evidence for laboratory diagnosis of Strongyloides infection in both immunosuppressed and immunocompetent patients.…”

Section: Discussionmentioning

confidence: 99%

Detection of Strongyloides stercoralis infection among cancer patients in a major hospital in Kelantan, Malaysia

Zueter¹,

Mohamed²,

Abdullah³

et al. 2014

smedj

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INTRODUCTION Strongyloidiasis is one of the most commonly neglected but clinically important parasitic infections worldwide, especially among immunocompromised patients. Evidence of infection among immunocompromised patients in Malaysia is, however, lacking. In this study, microscopy, real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assays (ELISAs) were used to detect Strongyloides stercoralis (S. stercoralis) infection among cancer patients in a Malaysian hospital.METHODS A total of 192 stool and serum samples were collected from cancer patients who were receiving chemotherapy with or without steroid treatment at a hospital in northeastern Malaysia. Stool samples were examined for S. stercoralis using parasitological methods and real-time PCR. Serology by ELISA was performed to detect parasite-specific immunoglobulin G (IgG), IgG4 and immunoglobulin E (IgE) antibodies. For comparison, IgG4-and IgG-ELISAs were also performed on the sera of 150 healthy individuals from the same area. RESULTSOf the 192 samples examined, 1 (0.5%) sample was positive for S. stercoralis by microscopy, 3 (1.6%) by real-time PCR, 8 (4.2%) by IgG-ELISA, 6 (3.1%) by IgG4-ELISA, and none was positive by IgE-ELISA. In comparison, healthy blood donors had significantly lower prevalence of parasite-specific IgG (2.67%, p < 0.05) and IgG4 (2.67%, p < 0.05) responses.CONCLUSION This study showed that laboratory testing may be considered as a diagnostic investigation for S. stercoralis among immunocompromised cancer patients.

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A Case of Fatal Strongyloidiasis in a Patient with Chronic Lymphocytic Leukemia and Molecular Characterization of the Isolate

Cited by 24 publications

References 10 publications

Single Donor-Derived Strongyloidiasis in Three Solid Organ Transplant Recipients: Case Series and Review of the Literature

Single Donor-Derived Strongyloidiasis in Three Solid Organ Transplant Recipients: Case Series and Review of the Literature

Strongyloidiasis: An Emerging Infectious Disease in China

Detection of Strongyloides stercoralis infection among cancer patients in a major hospital in Kelantan, Malaysia

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