Cargando…
Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease
INTRODUCTION: Strongyloidiasis is a neglected tropical disease with global prevalence. Under some cases of immune suppression (especially with corticosteroid administration), the nematode involved disseminates, leading to an amplified, possibly lethal hyper-infection syndrome. CASE PRESENTATION: A 5...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Microbiology Society
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230759/ https://www.ncbi.nlm.nih.gov/pubmed/30425838 http://dx.doi.org/10.1099/jmmcr.0.005165 |
_version_ | 1783370131118751744 |
---|---|
author | Khadka, Priyatam Khadka, Pratap Thapaliya, Januka Karkee, Dhana Bikram |
author_facet | Khadka, Priyatam Khadka, Pratap Thapaliya, Januka Karkee, Dhana Bikram |
author_sort | Khadka, Priyatam |
collection | PubMed |
description | INTRODUCTION: Strongyloidiasis is a neglected tropical disease with global prevalence. Under some cases of immune suppression (especially with corticosteroid administration), the nematode involved disseminates, leading to an amplified, possibly lethal hyper-infection syndrome. CASE PRESENTATION: A 56-year-old Nepalese man presenting with chief complaints of nausea, vomiting, joint pain and abdominal cramps was admitted to Sumeru Hospital. His past history revealed: chronic obstructive pulmonary disease (COPD), systemic hypertension and previously treated pulmonary tuberculosis. The patient had been treated with oral prednisolone (60 mg gl(−1)) for 8 days due to a presumed exacerbation of his COPD. Sequentially, he developed haemoptysis, chest tightness, frequent wheezing and worsening cough. Bronchoscopy showed severe diffuse alveolar haemorrhage; microbiological examination of broncho-alveolar lavage (BAL) was recommended. Examination of an acid fast bacilli stain preparation of BAL revealed filariform larvae of Strongyloides. Stool specimen examination revealed larvae of Strongyloides. The physical condition of the patient began to deteriorate; a few days after admission, vancomycin-sensitive Enterococcus faecium was isolated from a blood sample. He was treated with ivermectin and albendazole for strongyloides and linezolid plus vancomycin for E. faecium. However, the patient failed to recover from the illness and died. CONCLUSION: The findings of our study suggest that corticosteroid administration in strongyloidiasis can lead to the development of fatal strongyloides hyper-infection syndrome. Hence our experience suggests the need for early diagnosis of strongyloidiasis to avoid such an outcome. A deterioration of the patient's condition after the initiation of corticosteroid therapy in endemic areas should raise the possibility of strongyloidiasis. |
format | Online Article Text |
id | pubmed-6230759 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Microbiology Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-62307592018-11-13 Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease Khadka, Priyatam Khadka, Pratap Thapaliya, Januka Karkee, Dhana Bikram JMM Case Rep Case Report INTRODUCTION: Strongyloidiasis is a neglected tropical disease with global prevalence. Under some cases of immune suppression (especially with corticosteroid administration), the nematode involved disseminates, leading to an amplified, possibly lethal hyper-infection syndrome. CASE PRESENTATION: A 56-year-old Nepalese man presenting with chief complaints of nausea, vomiting, joint pain and abdominal cramps was admitted to Sumeru Hospital. His past history revealed: chronic obstructive pulmonary disease (COPD), systemic hypertension and previously treated pulmonary tuberculosis. The patient had been treated with oral prednisolone (60 mg gl(−1)) for 8 days due to a presumed exacerbation of his COPD. Sequentially, he developed haemoptysis, chest tightness, frequent wheezing and worsening cough. Bronchoscopy showed severe diffuse alveolar haemorrhage; microbiological examination of broncho-alveolar lavage (BAL) was recommended. Examination of an acid fast bacilli stain preparation of BAL revealed filariform larvae of Strongyloides. Stool specimen examination revealed larvae of Strongyloides. The physical condition of the patient began to deteriorate; a few days after admission, vancomycin-sensitive Enterococcus faecium was isolated from a blood sample. He was treated with ivermectin and albendazole for strongyloides and linezolid plus vancomycin for E. faecium. However, the patient failed to recover from the illness and died. CONCLUSION: The findings of our study suggest that corticosteroid administration in strongyloidiasis can lead to the development of fatal strongyloides hyper-infection syndrome. Hence our experience suggests the need for early diagnosis of strongyloidiasis to avoid such an outcome. A deterioration of the patient's condition after the initiation of corticosteroid therapy in endemic areas should raise the possibility of strongyloidiasis. Microbiology Society 2018-09-11 /pmc/articles/PMC6230759/ /pubmed/30425838 http://dx.doi.org/10.1099/jmmcr.0.005165 Text en © 2018 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Khadka, Priyatam Khadka, Pratap Thapaliya, Januka Karkee, Dhana Bikram Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease |
title | Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease |
title_full | Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease |
title_fullStr | Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease |
title_full_unstemmed | Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease |
title_short | Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease |
title_sort | fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230759/ https://www.ncbi.nlm.nih.gov/pubmed/30425838 http://dx.doi.org/10.1099/jmmcr.0.005165 |
work_keys_str_mv | AT khadkapriyatam fatalstrongyloidiasisaftercorticosteroidtherapyforpresumedchronicobstructivepulmonarydisease AT khadkapratap fatalstrongyloidiasisaftercorticosteroidtherapyforpresumedchronicobstructivepulmonarydisease AT thapaliyajanuka fatalstrongyloidiasisaftercorticosteroidtherapyforpresumedchronicobstructivepulmonarydisease AT karkeedhanabikram fatalstrongyloidiasisaftercorticosteroidtherapyforpresumedchronicobstructivepulmonarydisease |