<i>Strongyloides stercoralis</i>Eggs in a Urethral Smear after Bone Marrow Transplantation

Steiner, Beate; Riebold, D.; Wolff, Daniel; Freund, Mathias; Reisinger, Emil C.

doi:10.1086/339753

Cited by 29 publications

(22 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only four cases were reported from the whole of Africa [43-46], three of which in South Africa, a state where adequate diagnostic facilities are available. We collected 83/244 (34%) reports from North America (USA [47-109] and Canada [110-116]), 58/244 (24%) from Europe (Belgium [40,117], France [118-129], Germany [130,131], Greece [132-134], Italy [135-141], the Netherlands [142-145], Spain [146-155], Switzerland [156], UK [157-164]) and five (2%) from Oceania (Australia [165-168] and New Zealand [169]). In these areas of low/no endemicity, half of the patients were immigrants (70/146, 48%), while a few subjects were veterans (5/146, 3%) who presumably acquired the infection during military service in an endemic country.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Severe strongyloidiasis: a systematic review of case reports

et al. 2013

View full text Add to dashboard Cite

BackgroundStrongyloidiasis is commonly a clinically unapparent, chronic infection, but immuno suppressed subjects can develop fatal disease. We carried out a review of literature on hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), in order to describe the most challenging aspects of severe strongyloidiasis.MethodsWe conducted a structured search using PubMed to collect case reports and short case series on HS/DS published from 1991 to 2011. We restricted search to papers in English, Spanish, Italian and French. Case reports were classified as HS/DS according to given definitions.ResultsRecords screened were 821, and 311 were excluded through titles and abstract evaluation. Of 510 full-text articles assessed for eligibility, 213 were included in qualitative analysis. As some of them were short case series, eventually the number of cases analyzed was 244.Steroids represented the main trigger predisposing to HS and DS (67% cases): they were mostly administered to treat underlying conditions (e.g. lymphomas, rheumatic diseases). However, sometimes steroids were empirically prescribed to treat signs and symptoms caused by unsuspected/unrecognized strongyloidiasis. Diagnosis was obtained by microscopy examination in 100% cases, while serology was done in a few cases (6.5%). Only in 3/29 cases of solid organ/bone marrow transplantation there is mention of pre-transplant serological screening. Therapeutic regimens were different in terms of drugs selection and combination, administration route and duration. Similar fatality rate was observed between patients with DS (68.5%) and HS (60%).ConclusionsProper screening (which must include serology) is mandatory in high - risk patients, for instance candidates to immunosuppressive medications, currently or previously living in endemic countries. In some cases, presumptive treatment might be justified. Ivermectin is the gold standard for treatment, although the optimal dosage is not clearly defined in case of HS/DS.

show abstract

Section: Resultsmentioning

confidence: 99%

“…In the “other drugs” group we found mebendazole [9,17,44,48,131,137,181,218], cambendazole [35,36], levamisole [43,199], pyrantel pamoate [75,108], diethylcarbamazine [14]. …”

Section: Resultsmentioning

confidence: 99%

Severe strongyloidiasis: a systematic review of case reports

et al. 2013

View full text Add to dashboard Cite

show abstract

“…12 However, widespread dissemination involving extraintestinal organs such as the lung, skin, liver, kidneys, spleen, heart, brain, and meninges has also been described. [13][14][15][16] Pulmonary infection is often seen in the hyperinfection syndrome, and is also relatively common in the case of deep autoinfection in immunocompromised patients or those with cancer. 1 7 17-19 However, our patient was immunocompetent and diabetes, malnutrition, alcoholism, and corticosteroids treatment were absent, so that initially a tumour was suspected.…”

Section: Discussionmentioning

confidence: 99%

Strongyloides stercolarisinfection mimicking a malignant tumour in a non-immunocompromised patient. Diagnosis by bronchoalveolar cytology

Mayayo

Gómez-Aracil²,

Azúa-Blanco³

et al. 2005

J Clin Pathol

View full text Add to dashboard Cite

Autoinfective strongyloidiasis is often fatal in immunosuppressed patients or in immunocomprised hosts. An interesting case ofStrongyloides stercolarishyperinfection was seen in an immunocompetent patient. This report describes a case of fatal strogyloidiasis in a 79 year old man, who had suffered gastrointestinal discomfort for years, and who presented because of respiratory illness. A chest radiograph showed an irregular mass close to the mediastinum and interstitial infiltrates, but blood eosinophilia was not observed. Cytological examination of the samples obtained from bronchial aspiration and brushing identified several filariform larvae. Thus, cytology was essential for the correct diagnosis in this patient and is a very reliable method to diagnose lung parasitosis.

show abstract

“…One intriguing case documented the presence of S. stercoralis eggs containing viable larvae on a urethral smear (114). A suggestion raised by the authors is that normal hatching of larvae from the eggs was prevented by drugs used for the bone marrow transplant (busulfan and cyclophosphamide), although no in vitro evidence has been presented to explore this possibility further.…”

Section: Bone Marrow Transplantsmentioning

confidence: 99%

Strongyloides stercoralisin the Immunocompromised Population

2004

View full text Add to dashboard Cite

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

show abstract

Strongyloides stercoralisEggs in a Urethral Smear after Bone Marrow Transplantation

Cited by 29 publications

References 6 publications

Severe strongyloidiasis: a systematic review of case reports

Severe strongyloidiasis: a systematic review of case reports

Strongyloides stercolarisinfection mimicking a malignant tumour in a non-immunocompromised patient. Diagnosis by bronchoalveolar cytology

Strongyloides stercoralisin the Immunocompromised Population

Contact Info

Product

Resources

About