Strongyloides Stercoralis Infection With Bloody Pericardial Effusion in a Non-Immunosuppressed Patient.

Lai, Cha-Po; Hsu, Yung‐Hsiang; Wang, Ji-Hung; Lin, Chi-Mo

doi:10.1253/circj.66.613

Cited by 18 publications

(12 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The parasite feeds on human and non-human primate hosts, and generally causes a benign cutaneous and/or gastrointestinal infection. One patient in this series, whose condition has been previously reported, 15 had SS infection with bloody pericardial effusion, which later developed into constrictive pericarditis requiring total pericardiectomy. According to the Center for Disease Control in Taiwan, 16 the prevalence of Tb cases has increased dramatically during the period from 1990 to 2001, which may explain why Tb was a major cause of constrictive pericarditis in this study.…”

Section: Discussionmentioning

confidence: 74%

Clinical Characteristics and Treatment of Constrictive Pericarditis in Taiwan

Chen

Lai

2005

Circ J

Self Cite

View full text Add to dashboard Cite

onstrictive pericarditis, an uncommon disease, is a chronic fibrous thickening of the pericardium that prevents the normal diastolic filling of the heart. Surgery is the only satisfactory treatment. Many factors associated with the development of constrictive pericarditis have been identified, such as infection, post heart surgery, post mediastinal irradiation, but in Western countries the spectrum of etiology has shifted from infection, especially Mycobacterium tuberculosis (Tb), to post heart surgery, although idiopathic causes still predominate. [1][2][3][4] In endemic areas, however, Tb remains the most common cause of constrictive pericarditis. 5,6 Thirteen years experience of constrictive pericarditis patients who underwent total pericardiectomy in a university hospital located in a rural area of Taiwan were reviewed and the clinical characteristics, especially the etiological spectrum, and operative approach were analyzed. MethodsWe retrospectively analyzed the characteristics of 23 patients (19 males, 4 females, age range 25-65 years) who underwent total pericardiectomy for constrictive pericarditis between January 1990 and December 2003. Constrictive pericarditis was diagnosed by chest roentgenography (calcified pericardium), computed tomography scan (thickened pericardium and/or pleural effusion), 7 and confirmed by cardiac catheterization (elevated end-diastolic pressure and classic "square root sign" of right ventricular pressure tracing). 8,9 The etiological factors evaluated included underlying diseases, microbiological culture results, and histopathological findings. Tubercular pericarditis was diagnosed if the histopathological section of pericardium showed the granulomatous changes of Tb. Table 1 shows the clinical characteristics of the study group prior to operation. The most common symptoms were exertional dyspnea (96%), jugular vein distension (96%), hepatomegaly (70%), general fatigue (65%), peripheral edema (65%), and ascites (52%). Pathogens isolated in 11 patients (48%) were Tb in 8 patients (35%) and streptococcus in 2 patients (9%); 1 patient had strongyloidiasis Results Clinical Characteristics and Treatment of Constrictive Pericarditis in TaiwanRobert Fu-Chean Chen, MD; Cha-Po Lai, MD* Background Constrictive pericarditis is an uncommon disease that prevents the normal diastolic filling of the heart and pericardiectomy is the only satisfactory treatment. Methods and ResultsThe clinical characteristics and treatment of patients who underwent pericardiectomy for constrictive pericarditis (n=23) were reviewed. Surgery was performed via left anterolateral thoracotomy plus transsternal extension in 3 patients, and median sternotomy in 20 patients. There were 2 deaths, resulting in an overall mortality rate of 8.7%. Of the 23 patients, 8 had Mycobacterium tuberculosis (Tb) infection, 2 had streptococcus infection, 1 had strongyloidiasis (Strongyloides stercoralis) and 1 developed the condition after a myocardial infarction; 2 patients underwent pericardial substitute insertion as post-hea...

show abstract

Section: Discussionmentioning

confidence: 74%

Clinical Characteristics and Treatment of Constrictive Pericarditis in Taiwan

Chen

Lai

2005

Circ J

Self Cite

View full text Add to dashboard Cite

show abstract

“…This does not necessarily imply a greater severity of disease. Extrapulmonary migration of larvae has been shown to occur routinely during the course of exper- (57). Similarly, many cases of hyperinfection are fatal without larvae being detected outside the pulmonary autoinfective route.…”

Section: Disseminated Infectionmentioning

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

“…However, in recent years, S. stercoralis has been increasingly detected in cytologic specimens due to the higher registered numbers of immunosuppressed patients. During hyperinfection, larvae can be detected in a variety of body fluids (Lai et al, 2002;Steiner et al, 2002;Premanand et al, 2003;Hong et al, 2004), and are most frequently observed in sputum smears, which reflects respiratory tract involvement in both the normal life cycle and in cases of disseminated autoinfection (Humphreys and Hieger, 1979;Chaudhuri et al, 1980;Harris et al, 1980;Wang et al, 1980). Microscopically, there are two common types of S. stercoralis larvae, rhabditoid (L1) and filariform (L3).…”

Section: Introductionmentioning

confidence: 99%

A case of fatal hyperinfective strongyloidiasis with discovery of autoinfective filariform larvae in sputum

Kim

Joo

et al. 2005

Korean J Parasitol

View full text Add to dashboard Cite

Abstract:The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 ± 21.2 µm in length and 11 ± 0.6 µm in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.

show abstract

Strongyloides Stercoralis Infection With Bloody Pericardial Effusion in a Non-Immunosuppressed Patient.

Cited by 18 publications

References 4 publications

Clinical Characteristics and Treatment of Constrictive Pericarditis in Taiwan

Clinical Characteristics and Treatment of Constrictive Pericarditis in Taiwan

Strongyloides stercoralisin the Immunocompromised Population

A case of fatal hyperinfective strongyloidiasis with discovery of autoinfective filariform larvae in sputum

Contact Info

Product

Resources

About