A case of hyperinfection syndrome with Strongyloides stercoralis

Abstract

A case of Strongyloides stercoralis infection wss experienced in a 73-year old Korean female patient, was hospitalized with relapse of cholecystitis. The patient developed cough and dyspnea 17 days after the admission. On the 27th hospitalized day, diarrhoea, nausea, vomiting and abdominal pain started. A number of parasitic larvae were incubated at 25 degrees C for 2 days. Typical fork tailed filariform larvae of S. stercoralis (Bavay, 1876) Stiles and Hassall, 1902, were identified after cultivation. There was no improvement of diarrhoea after the medication with mebendazole. After the administration of thiabendazole, however, diarrhoea was stopped. On the 6th day of medication, S. stercoralis larvae were no more detected, and thereafter no larva was observed by repeated stool examinations upto 2 months after chemotherapy. The patient had the history of administration of steroid for articular rheumatism. Therefore this case seems to be a hyperinfection of S. stercoralis due to an autoinfection and to be the first report on the hyperinfected strongyloidiasis in Korea. Related literature was briefly reviewed.

Acute Respiratory Distress Syndrome With Alveolar Hemorrhage due to Strongyloidiasis Hyperinfection in an Older Patient

“… 1) In Korea, which is in a temperate zone, several cases of Strongyloides hyperinfection have been reported, but these have been mostly associated with gastrointestinal involvement. 2 – 4) Two cases of pulmonary strongyloidiasis with acute respiratory failure and alveolar hemorrhage 5 , 6) have been reported, but these cases involved an immuno-suppressed state owing to lung cancer and chemotherapy. I report a case of acute respiratory distress syndrome (ARDS) in an older patient without known immunosup-pressive conditions, with alveolar hemorrhage and S .…”

Pulmonary Strongyloidiasis Masquerading as Exacerbation of Chronic Obstructive Pulmonary Disease

“…In general, there is a low prevalence of Strongyloides infections in Korea as only few cases have been reported. Majority of reported cases belong to gastrointestinal strongyloidiasis 12 13 14 . A case of gastrointestinal hyperinfection with Strongyloides was confirmed by examination of gastric biopsy and gastroduodenal aspirate in an elderly lady receiving corticosteroid for arthritis 15 .…”

A Case of Hyperinfection with Strongyloides Stercoralis in an Immunosuppressed Patient

“…Strongyloides stercoralis is a soil-transmitted nematode of worldwide distribution, but a high incidence of infection is correlated with low socioeconomic areas in temperate zones 1 , 2 ) .…”

“…Purtilo et al reported thirty-two cases of fatal strongyloidiasis in immunosuppressed patients 5 ) . In Korea, only one case of strongyloidiasis hyperinfection was reported by Choi et al in 1985 until now 1 ) .…”