<i>Strongyloides stercoralis</i>Infection in Alcoholic Patients

Teixeira, Márcia Cristina Aquino; Pacheco, Flávia Thamiris Figueiredo; Souza, Joelma Nascimento de; Silva, Mônica L. S.; Inês, Elizabete J; Soares, Neci Matos

doi:10.1155/2016/4872473

Cited by 40 publications

(42 citation statements)

References 122 publications

(153 reference statements)

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“…In this case series, few patients had risk factors for strongyloidiasis other than HTLV-1 infection, including recent steroid use (3), organ transplant (4), or cirrhosis (27,28). In areas with HTLV-1 endemicity, HTLV-1 infection is the major risk factor for both chronic strongyloidiasis and dissemination (29).…”

Section: Discussionmentioning

confidence: 88%

Clinical Characteristics of Disseminated Strongyloidiasis, Japan, 1975–2017

Mukaigawara¹,

Narita²,

Shiiki³

et al. 2020

Emerg. Infect. Dis.

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Clinical characteristics of disseminated strongyloidiasis, the severest form of strongyloidiasis, are not well described. We conducted a retrospective, consecutive chart review of patients with disseminated strongyloidiasis admitted to Okinawa Chubu Hospital in Okinawa, Japan, during January 1975-December 2017. The 70 patients were classified into 3 clinical phenotypes: dissemination (32 patients [45.7%]), occult dissemination with meningitis caused by enteric organisms (12 patients [17.1%]), and occult dissemination with culture-negative suppurative meningitis (26 patients [37.1%]). Associated mortality rates were 56.3%, 16.7%, and 11.5%, respectively, and sepsis occurred in 40.6%, 58.3%, and 11.5% of cases, respectively. Common symptoms included fever (52.9% of patients), headache (32.9%), and altered mental status (24.3%). Patients were treated with thiabendazole (before 2003) or ivermectin (after 2003). Our findings show that disseminated strongyloidiasis has clinical phenotypes in terms of severity and that identification of occult dissemination, a mild form with prominent neurologic manifestations, is lifesaving. In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; and (4) view/print certificate. For CME questions, see page 637.

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Section: Discussionmentioning

confidence: 88%

Clinical Characteristics of Disseminated Strongyloidiasis, Japan, 1975–2017

Mukaigawara¹,

Narita²,

Shiiki³

et al. 2020

Emerg. Infect. Dis.

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“…Alcoholic individuals usually practice lower hygienic habits, and the consequence of this can be demonstrated by the elevated frequency of intestinal parasites [ 9 , 10 , 11 ]. In this study, most individuals lived in the state capital city, Salvador, and had access to a sewage system, paved streets, daily garbage collection, running water, and a bathroom at home.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of S. stercoralis infection in alcoholic patients is reported to be approximately five times higher than that in the general population [ 9 , 10 , 11 ]. One possible mechanism includes an alteration in the hypothalamic–pituitary–adrenal (HPA) axis function, raising the levels of endogenous corticosteroids and its metabolites, which resemble an ecdysteroid hormone that regulates the fertility of S. stercoralis parthenogenetic females, induces the transformation of rhabditiform to infective filariform larvae, and increases the autoinfection rate [ 11 ]. A recent study by our group has demonstrated that increased endogenous cortisol levels is directly related to parasite load [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Strongyloides stercoralis in Alcoholic Patients: Implications of Alcohol Intake in the Frequency of Infection and Parasite Load

et al. 2020

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Strongyloides stercoralis infection in immunocompromised subjects, including chronic alcoholics, can lead to a severe disease. Moreover, its prevalence in alcoholic patients seems to be higher than that in the general population. The aims of this study were to evaluate the frequency of S. stercoralis infection in alcoholic patients and to investigate the influence of alcohol intake on the parasite load, as well as to evaluate the sensitivity of three different parasitological methods according to the larval output. Fecal samples of 1290 chronic alcoholic patients were examined by spontaneous sedimentation, Baermann–Moraes, and agar plate culture (APC) methods. S. stercoralis was the most frequent parasite found (14.5%; n = 187). Alcoholic individuals infected with Strongyloides stercoralis had a higher daily consumption of alcohol than those who were not infected, 528.6 and 403.0 g/day, respectively (p < 0.05). In addition, individuals with higher alcohol intake presented an increase in parasite load. The S. stercoralis diagnostic method with the highest sensitivity was APC, 97.9% (183/187). In conclusion, S. stercoralis seems to be the most frequent parasite found in alcoholic individuals from endemic areas and alcohol intake is positively associated with S. stercoralis larvae output. In addition, this study confirms that APC is the most sensitive parasitological method used for Strongyloides diagnosis.

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“…Several immunosuppression-related risk factors for Strongyloides hyperinfection have been described including the use of corticosteroids and other immunosuppressants, HTLV-1 infection, organ transplantation, and hematologic malignancies 1 , 7 . Other predisposing factors are malnutrition, alcoholism, and diabetes mellitus 1 , 8 , 9 . These three conditions were present in the patient whose case we report.…”

Section: Discussionmentioning

confidence: 99%

Fatal Strongyloides stercoralis hyperinfection syndrome in an alcoholic diabetic patient from México

et al. 2020

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Strongyloides stercoralis hyperinfection syndrome is a medical emergency that requires a high level of suspicion. Immunocompromised patients are at high risk of hyperinfection syndrome; however, malnutrition, alcoholism, and diabetes mellitus also need to be considered as predisposing factors. The diagnosis and treatment of Strongyloides hyperinfection are challenging and patients often have severe complications. Consequently, mortality is overwhelmingly high, with proportions above 60%.Herein, we report a case of Strongyloides hyperinfection in a 40-year-old alcoholic diabetic patient living in México. Unfortunately, the late diagnosis resulted in his death despite the treatment and supportive measures. Increased awareness is needed to prevent the dire consequences of strongyloidiasis.

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Strongyloides stercoralisInfection in Alcoholic Patients

Cited by 40 publications

References 122 publications

Clinical Characteristics of Disseminated Strongyloidiasis, Japan, 1975–2017

Clinical Characteristics of Disseminated Strongyloidiasis, Japan, 1975–2017

Strongyloides stercoralis in Alcoholic Patients: Implications of Alcohol Intake in the Frequency of Infection and Parasite Load

Fatal Strongyloides stercoralis hyperinfection syndrome in an alcoholic diabetic patient from México

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