Disseminated strongyloidiasis presenting as purpura

Ronan, Salve G.; Reddy, Ramakrishna L.; Manaligod, José R.; Alexander, Julia; Fu, Tony

doi:10.1016/s0190-9622(89)70311-x

Cited by 41 publications

(19 citation statements)

References 16 publications

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“…Petechial and purpuric lesions on the lower abdomen and thighs have been documented in the literature [6,7]. Purpura is attributed to the invasion of the dermis by larvae that migrate through the vessel walls [8].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, clinical suspicion is essential for early diagnosis and improvement in survival. Cutaneous manifestations in disseminated strongyloidiasis are infrequent, but they may be a valuable diagnostic sign [3][4][5][6][7]. We report six immunosuppressed cancer patients with proven diagnosis of disseminated strongyloidiasis presenting with periumbilical purpura and septic shock.…”

mentioning

confidence: 95%

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Cutaneous periumbilical purpura in disseminated strongyloidiasis in cancer patients: a pathognomonic feature of potentially lethal disease?

Salluh¹,

Bozza²,

Pinto³

et al. 2005

Braz J Infect Dis

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Cutaneous manifestations in disseminated strongyloidiasis are infrequent but should raise the suspicion for its diagnosis. We retrospectively evaluated the charts of six patients with cancer and a proven diagnosis of disseminated strongyloidiasis. All patients had received prophylaxis with albendazole before starting antineoplastic therapy, which included high-dose steroids. They presented with septic shock, acute respiratory failure and characteristic purpuric periumbilical skin lesions. Strongyloides larvae were identified in tracheal aspirates (n=5), gastric aspirates (n=4), lung (n=2) and skin biopsies (n=2). All patients died despite antihelminthic therapy and intensive care support.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 95%

Cutaneous periumbilical purpura in disseminated strongyloidiasis in cancer patients: a pathognomonic feature of potentially lethal disease?

Salluh¹,

Bozza²,

Pinto³

et al. 2005

Braz J Infect Dis

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“…Some case reports do not mention any gastrointestinal symptoms (97). Abdominal pain (12), often described as crampy (61) or bloating (20) in nature, watery diarrhea, constipation (61), anorexia, weight loss (61,108), difficulty swallowing (136), sore throat (136), nausea (61), vomiting (61), and gastrointestinal bleeding (13), in any order or combination, are frequently reported.…”

Section: Gastrointestinal Manifestationsmentioning

confidence: 99%

“…Spinal fluid cultures in hyperinfection have grown Escherichia coli (56,97), Proteus mirabilis (12), Klebsiella pneumoniae (61), Enterococcus faecalis (56), and Streptococcus bovis (53,63), among others. Eosinophilic meningitis has not been reported.…”

Section: Central Nervous System Manifestationsmentioning

confidence: 99%

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Strongyloides stercoralisin the Immunocompromised Population

2004

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Strongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. S. stercoralis is unique among intestinal nematodes in its ability to complete its life cycle within the host through an asexual autoinfective cycle, allowing the infection to persist in the host indefinitely. Under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome, characterized by increased numbers of infective filariform larvae in stool and sputum and clinical manifestations of the increased parasite burden and migration, such as gastrointestinal bleeding and respiratory distress. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment and human T-lymphotropic virus type 1 infection are the two conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelmintic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome as well as for primary and secondary prevention of hyperinfection in patients whose exposure history and underlying condition put them at increased risk

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StrongyloidesandCapillaria

Cappello

Hotez

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

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Disseminated strongyloidiasis presenting as purpura

Cited by 41 publications

References 16 publications

Cutaneous periumbilical purpura in disseminated strongyloidiasis in cancer patients: a pathognomonic feature of potentially lethal disease?

Cutaneous periumbilical purpura in disseminated strongyloidiasis in cancer patients: a pathognomonic feature of potentially lethal disease?

Strongyloides stercoralisin the Immunocompromised Population

StrongyloidesandCapillaria

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