Wed, Nov 13, 2024
Volume 13, Issue 6 (Nov-Dec 2019)
mljgoums 2019, 13(6): 51-54 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Meamar A, jalallou N, Masoori L, Alipour M. Disseminated and Hyperinfection Fatal Strongyloidiasis in Two Patients on Immunosuppressive Therapy: A Case Report. mljgoums 2019; 13 (6) :51-54
URL: http://mlj.goums.ac.ir/article-1-1138-en.html
URL: http://mlj.goums.ac.ir/article-1-1138-en.html
1- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2- Department of Medical Laboratory Science, AJA University of Medical Sciences, Tehran, Iran ,nahidjalallou@yahoo.com
3- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences
2- Department of Medical Laboratory Science, AJA University of Medical Sciences, Tehran, Iran ,
3- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences
Abstract: (3985 Views)
ABSTRACT
Background and Objective: Strongyloides infection is usually asymptomatic in healthy individuals; however, immunocompromised patients are subject to potential hyperinfection involvement. Hereby, we report disseminated and hyperinfection strongyloidiasis in two immunosuppressed patients from north of Iran, an endemic region for Strongyloides stercoralis.
Case description: After assessment of clinical symptoms, disseminated strongyloidiasis was identified in the first case with pemphigus vulgaris by the presence of abundant larvae in direct stool smears and gastric biopsy. The second patient had metastatic carcinoma and was hospitalized with complicated symptoms. The infection was diagnosed by detection of numerous first-stage larvae in wet mount stool smears and agar plate analysis. Despite antiparasitic treatment, both patients died during the hospitalization.
Conclusion: Delayed diagnosis of active strongyloidiasis in immunosuppressed patients can lead to hyperinfection syndrome. Thus, screening for S. stercoralis infection in these patients is recommended in endemic regions to reduce mortalities.
Keywords: Strongyloides stercoralis, Disseminated strongyloidiasis, Hyperinfection.
Background and Objective: Strongyloides infection is usually asymptomatic in healthy individuals; however, immunocompromised patients are subject to potential hyperinfection involvement. Hereby, we report disseminated and hyperinfection strongyloidiasis in two immunosuppressed patients from north of Iran, an endemic region for Strongyloides stercoralis.
Case description: After assessment of clinical symptoms, disseminated strongyloidiasis was identified in the first case with pemphigus vulgaris by the presence of abundant larvae in direct stool smears and gastric biopsy. The second patient had metastatic carcinoma and was hospitalized with complicated symptoms. The infection was diagnosed by detection of numerous first-stage larvae in wet mount stool smears and agar plate analysis. Despite antiparasitic treatment, both patients died during the hospitalization.
Conclusion: Delayed diagnosis of active strongyloidiasis in immunosuppressed patients can lead to hyperinfection syndrome. Thus, screening for S. stercoralis infection in these patients is recommended in endemic regions to reduce mortalities.
Keywords: Strongyloides stercoralis, Disseminated strongyloidiasis, Hyperinfection.
Research Article: Case Report |
Subject:
Parasitology
Received: 2018/11/11 | Accepted: 2019/05/8 | Published: 2019/10/30 | ePublished: 2019/10/30
Received: 2018/11/11 | Accepted: 2019/05/8 | Published: 2019/10/30 | ePublished: 2019/10/30
References
1. Toledo R, Muñoz-Antoli C, Esteban JG. Strongyloidiasis with emphasis on human infections and its different clinical forms. Adv Parasitol 2015; 88: 165-241. [DOI:10.1016/bs.apar.2015.02.005]
2. Buonfrate D, Formenti F, Perandin F, Bisoffi Z. Novel approaches to the diagnosis of Strongyloides stercoralis infection. Clin Microbiol Infect. 2015; 21(6): 543-52. [DOI:10.1016/j.cmi.2015.04.001]
3. Rokni MB. The present status of human helminthic diseases in Iran. Ann Trop Med Parasitol 2008; 102(4): 283-295. [DOI:10.1179/136485908X300805]
4. Geri G, Rabbat A, Mayaux J, Zafrani L, Chalumeau-Lemoine L, Guidet B, et al. Strongyloides stercoralis hyperinfection syndrome: a case series and a review of the literature. Infection 2015; 43(6): 691-8. [DOI:10.1007/s15010-015-0799-1]
5. Tabei SZ, Asadian F, Fakhar M, Safaei A. Gastrointestinal hyperinfection due to Strongyloides stercoralisin a patient with Behcet's syndrome. Comp Clin Pathol 2009; 18: 89-91. [DOI:10.1007/s00580-008-0750-2]
6. Keiser PB. andNutman TB. Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev 2004; 17(1): 208-217. [DOI:10.1128/CMR.17.1.208-217.2004]
7. Reddy I S, Swarnalata G. Fatal disseminated strongyloidiasis in patients on immunosuppressive therapy: Report of two cases. Indian J Dermatol Venereol Leprol 2005; 71(1): 38-40. [DOI:10.4103/0378-6323.13785]
8. Sarubbi FA. Hyperinfection with Strongyloides during treatment of pemphigus vulgaris. Arch Dermatol 1987; 123(7): 864-5. [DOI:10.1001/archderm.1987.01660310028005]
9. Fakhar M, Gholami Z, Banimostafavi ES, Madjidi H. Respiratory hyperinfection caused by Strongyloides stercoralis in a patient with pemphigus vulgarisand mini review on diagnosis and treatment of strongyloidiasis. Comp Clin Pathol 2010; 19: 621-625 [DOI:10.1007/s00580-010-0995-4]
10. Buonfrate D, Requena-Mendez A, Angheben A, Muñoz J, Gobbi F, Van Den Ende J, Bisoffi Z. Severe strongyloidiasis: a systematic review of case reports. BMC Infect Dis 2013; 13(1): 78 [DOI:10.1186/1471-2334-13-78]
11. Concha R, Harrington Jr W, Rogers Al. Intestinal strongyloidiasis: recognition, management, and determinants of outcome. J Cli Gastroenterol. 2005; 39(3): 203-211. [DOI:10.1097/01.mcg.0000152779.68900.33]
12. Vadlamudi RS, Chi DS, Krishnaswamy G. Intestinal strongyloidiasis and hyperinfection syndrome. Clin Mol Allergy 2006; 4: 8. [DOI:10.1186/1476-7961-4-8]
13. Weatherhead JE, Mejia R. Immune Response to Infection with Strongyloides stercoralis in patients with infection and hyperinfection. Curr Trop Med Rep 2014; 1:229 - 233. [DOI:10.1007/s40475-014-0032-9]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Enamad
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.