Pulmonary Strongyloidiasis Masquerading as Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy.

An Unusual Cause of Bilateral Pneumothoraces

“…Strongyloidiasis presenting as an acute exacerbation of COPD has also been reported. [7][8][9] Non-specific signs and symptoms, use of corticosteroids for managing the exacerbations which blunt the eosinophilic response in addition to indiscriminate self-medication with corticosteroids by COPD patients enhance the possibility of hyperinfection syndrome and disseminated stronglyoidiasis and pose a major challenge in diagnosing and managing these patients.…”

Strongyloides Hyperinfection After Immunosuppression in an Immigrant From El Salvador

“…During the acute phase of S. stercoralis infection, symptoms include vague pulmonary, gastrointestinal, or cutaneous manifestations 3,9,10 (Fig. 3).…”

A Rare Case of Strongyloides Hyperinfection from Hypogammaglobulinemia

“…Strongyloides infection can have variable presentation ranging from asymptomatic eosinophilia in immunocompetent host to disseminated disease with sepsis. It can also present as acute exacerbation of COPD[ 1 ] inflammatory bowel disease. [ 2 ]…”