Clinical and Imaging Features of Pulmonary Strongyloidiasis

Woodring, John H.; Halfhill, H; Berger, Rolando; Reed, James C.; Moser, Neal J.

doi:10.1097/00007611-199601000-00002

Cited by 54 publications

(52 citation statements)

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“…Some studies have reported a low body temperature, coughing, laryngismus paralytics, and blood-stained sputum as possible symptoms (7,8). In the absence of early diagnosis and treatment, the prognosis of disseminated strongyloidiasis is extremely poor (6,9,11,13). Some studies have reported that a patient's prognosis is related to the severity of their underlying condition (9).…”

Section: Discussionmentioning

confidence: 99%

“…Chest imaging in patients with pulmonary strongyloidiasis reveals non-segmental patchy areas of consolidation, diffuse reticulonodular patterns and diffuse pulmonary opacities (16). Sometimes lung abscess is also seen (9,12). These chest imaging findings and many of the respiratory symptoms in patients with disseminated strongyloidiasis are thought to be caused by one of the following three mechanisms (11,14,17).…”

Section: Discussionmentioning

confidence: 99%

“…These underlying conditions may cause respiratory failure, at which time the filariform larvae may also be recognized in the individual's sputum. At this stage, chest X-rays may reveal various patterns, such as alveolar and interstitial shadow patterns, lobar pneumonia, etc (8,9,17). Finally, bacterial pneumonia, a complication of pulmonary strongyloidiasis, might be caused by the "piggyback" transport of bacteria from the intestines (11).…”

Section: Discussionmentioning

confidence: 99%

“…Although S. stercoralis can cause a severe pathologic state, the initial symptoms are very mild and nonspecific (9). In endemic areas of S. stercoralis, strongyloidiasis should be included as a possible cause of pulmonary disease in differential diagnoses, especially in patients with immunodeficiencies and abnormal chest imaging findings, like alveolar and interstitial shadow patterns or lobar pneumonia.…”

Section: Discussionmentioning

confidence: 99%

“…As with hyperinfection syndrome, disseminated strongyloidiasis has been reported to occur in 1.5-2.5% of all strongyloidiasis (5). In the absence of early diagnosis and treatment, the prognosis of disseminated strongyloidiasis is extremely poor (6)(7)(8)(9). One study reported that the mortality rate for disseminated strongyloidiasis is as high as 77% among compromised hosts (10).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Pulmonary Strongyloidiasis in a Patient Receiving Prednisolone Therapy

Namisato

Motomura²,

Haranaga

et al. 2004

Intern. Med.

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Strongyloidiasis is widely distributed in tropical and subtropical areas. Disseminated strongyloidiasis may develop in patients with immunodeficiencies. In the absence of early diagnosis and treatment, the prognosis of disseminated strongyloidiasis is extremely poor. We report a case of pulmonary strongyloidiasis that was successfully treated. The patient was an 83-year-old woman who had been receiving long-term oral prednisolone therapy for uveitis. The patient visited our emergency department complaining of breathing difficulties and diarrhea. A chest X-ray revealed a diffuse enhancement of interstitial shadows. A bronchoalveolar lavage (BAL) was performed, and both Gram staining and Grocott's staining revealed the presence of multiple filariform larvae of Strongyloides stercoralis in the bronchoalveolar lavage fluid (BALF). A stool examination performed at the same time also yielded S. stercoralis. The patient was diagnosed as having pulmonary strongyloidiasis and was treated with thiabendazole and ivermectin, in addition to antimicrobial agents; her respiratory symptoms and diarrhea improved, and S. stercoralis was not detected in subsequent follow-up examinations thereafter. In endemic areas of S. stercoralis, pulmonary strongyloidiasis should be considered as part of a differential diagnosis if chest imaging findings like alveolar and interstitial shadow patterns or lobar pneumonia are seen in patients with immunodeficiencies. (Internal Medicine 43: 731-736, 2004)

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Section: Discussionmentioning

confidence: 99%