Case Report: Challenges for the Diagnosis and Treatment of Strongyloides stercoralis in Chronic Obstructive Pulmonary Disease Patients
- PMID: 34844210
- PMCID: PMC8832893
- DOI: 10.4269/ajtmh.21-1011
Case Report: Challenges for the Diagnosis and Treatment of Strongyloides stercoralis in Chronic Obstructive Pulmonary Disease Patients
Abstract
Strongyloidiasis, a neglected tropical disease (NTD), which is caused by Strongyloides stercoralis, can be fatal in immunocompromised patients. In most chronic cases, infections most frequently are asymptomatic, and eosinophilia might be the only clinical characteristic of this disease. The use of corticosteroids in some diseases like chronic obstructive pulmonary disease (COPD) may lead to the development of the life-threatening S. stercoralis hyperinfection syndrome. In the present research, we presented five cases of strongyloidiasis with a history of COPD and receiving corticosteroids from Abadan County, southwestern Iran. By performing the direct smear stool examinations, two cases were identified and the other three cases were diagnosed using the agar plate culture method. Despite reporting eosinophilia in previous patients' hospitalizations, the fecal examination was not performed for parasitic infections. Moreover, pulmonary symptoms were similar, but gastrointestinal symptoms were varied, including nausea, vomiting, abdominal pain, epigastric pain, constipation, and diarrhea. All the included patients were treated with albendazole, which is the second-line drug for S. stercoralis, and relapse of infection was observed in two patients by passing few months from the treatment. The increased blood eosinophil count was shown to play important roles in both the management of COPD and diagnosis of helminthic infections. In COPD patients who are receiving steroids, screening and follow-up for strongyloidiasis should be considered as priorities. In addition, ivermectin, which is the first-line drug for strongyloidiasis, should be available in the region.
Figures
Similar articles
-
Screening of Strongyloides stercoralis infection in high-risk patients in Khuzestan Province, Southwestern Iran.Parasit Vectors. 2021 Jan 9;14(1):37. doi: 10.1186/s13071-020-04549-6. Parasit Vectors. 2021. PMID: 33422116 Free PMC article.
-
[An overview of Strongyloides stercoralis and its infections].Mikrobiyol Bul. 2009 Jan;43(1):169-77. Mikrobiyol Bul. 2009. PMID: 19334396 Review. Turkish.
-
Streptococcus pyogenes bacteremia and toxic shock syndrome related to Strongyloides stercoralis hyperinfection: a case report.J Med Case Rep. 2018 Nov 22;12(1):346. doi: 10.1186/s13256-018-1885-7. J Med Case Rep. 2018. PMID: 30463627 Free PMC article.
-
Persistent eosinophilia and Strongyloides infection in Montagnard refugees after presumptive albendazole therapy.Am J Trop Med Hyg. 2009 Aug;81(2):302-4. Am J Trop Med Hyg. 2009. PMID: 19635888
-
A Fatal Strongyloides Stercoralis Hyperinfection Syndrome in a Patient With Chronic kidney Disease: A Case Report and Literature Review.Medicine (Baltimore). 2016 May;95(19):e3638. doi: 10.1097/MD.0000000000003638. Medicine (Baltimore). 2016. PMID: 27175679 Free PMC article. Review.
References
-
- Einsiedel L Fernandes L , 2008. Strongyloides stercoralis: a cause of morbidity and mortality for indigenous people in Central Australia. Intern Med J 38: 697–703. - PubMed
-
- Liu HC Hsu JY Chang KM , 2009. Strongyloides stercoralis hyperinfection presenting with symptoms mimicking acute exacerbation of chronic obstructive pulmonary disease. J Chin Med Assoc 72: 442–445. - PubMed
-
- Agustí A Vogelmeier C Faner R , 2020. COPD 2020: changes and challenges. Am J Physiol Lung Cell Mol Physiol 319: L879–L883. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical