From strongyloidiasis to disseminated mucormycosis: the story of an HTLV-1-infected migrant

2020 ◽  
Author(s):  
Brice Autier ◽  
Adélaïde Chesnay ◽  
Claire Mayence ◽  
Stéphanie Houcke ◽  
Hélène Guégan ◽  
...  
Keyword(s):  
Immune Deficiency ◽  
Strongyloides Stercoralis ◽  
The Body ◽  
Life Threatening ◽  
Disseminated Strongyloidiasis ◽  
Disseminated Mucormycosis

Strongyloidiasis manifestations range from asymptomatic cases to the life-threatening disseminated strongyloidiasis in case of immune deficiency: larvae migrate throughout the body, disseminating germs from the digestive flora to various organs. Here, we described a case of disseminated mucormycosis consecutive to Strongyloides stercoralis hyperinfestation in a Surinamese migrant infected with HTLV-1.

scholarly journals A Practical Approach to Screening for Strongyloides stercoralis

2021 ◽  
Vol 6 (4) ◽  
pp. 203
Author(s):  
Luisa Carnino ◽  
Jean-Marc Schwob ◽  
Laurent Gétaz ◽  
Beatrice Nickel ◽  
Andreas Neumayr ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Strongyloides Stercoralis ◽  
Accurate Diagnosis ◽  
Neglected Tropical Disease ◽  
Empiric Treatment ◽  
Screening Algorithm ◽  
Life Threatening ◽  
Disseminated Strongyloidiasis ◽  
Optimal Accuracy ◽  
Testing Array

Strongyloides stercoralis, causative agent of a neglected tropical disease, is a soil-transmitted helminth which may cause lifelong persisting infection due to continuous autoinfection. In the case of immunosuppression, life-threatening hyperinfection and disseminated strongyloidiasis can develop. We propose a pragmatic screening algorithm for latent strongyloidiasis based on epidemiologic exposure and immunosuppression status that can be applied for any kind of immunosuppressive therapy. The algorithm allows the diagnosis of latent strongyloidiasis with optimal accuracy in a well-equipped setting, while for endemic settings where the complete testing array is unavailable, an empiric treatment is generally recommended. Accurate diagnosis and extensive empiric treatment will both contribute to decreasing the current neglect of strongyloidiasis.

scholarly journals Mucormycosis: A challenge with COVID-19

2021 ◽  
Author(s):  
Mohammod Kamrul Islam
Keyword(s):  
Early Diagnosis ◽  
Fungal Infection ◽  
Paranasal Sinuses ◽  
The Body ◽  
Affected Patient ◽  
Life Threatening ◽  
Disseminated Mucormycosis ◽  
Mucor Species

Mucormycosis is an aggressive opportunistic fungal infection caused by fungi of the Phycomycetes class including Rhizopus species and Mucor species. The pathogen can be present in the environment, on the skin, and in the orifices of the body. There are several types including Rhinocerebral, Pulmonary, Gastrointestinal, Cutaneous, and Disseminated Mucormycosis.1 The spores infect the paranasal sinuses and nasopharynx, extending to the orbit and brain cavity in persons who have reduced cellular and humoral defenses. During the ongoing COVID-19 pandemic, a surge in the cases of rhino-orbital mucormycosis has become a life-threatening combination. Early diagnosis and intervention in the only way to save the vision and life of the affected patient.

scholarly journals Fatal Outcome of Disseminated Strongyloidiasis despite Detectable Plasma and Cerebrospinal Levels of Orally Administered Ivermectin

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Charles E. Rose ◽  
Christopher A. Paciullo ◽  
David R. Kelly ◽  
Mark J. Dougherty ◽  
Lawrence L. Fleckenstein
Keyword(s):  
Standard Treatment ◽  
Fatal Outcome ◽  
Strongyloides Stercoralis ◽  
The Body ◽  
Lymphocytic Leukemia ◽  
Immunodeficiency Virus ◽  
Disseminated Strongyloidiasis ◽  
Repeated Dosing ◽  
Csf Concentration ◽  
System Organ

Strongyloides stercoralisaffects over 100 million people worldwide. Those people most susceptible to infection are those with an immunocompromising condition, such as cancer or human immunodeficiency virus (HIV). Local disease may spread throughout the body of the host, causing a condition termed disseminated strongyloidiasis. Standard treatment forStrongyloides stercoralisinfection is oral ivermectin. We describe a patient with chronic lymphocytic leukemia diagnosed with disseminated strongyloidiasis two weeks after initial presentation. After repeated dosing of oral ivermectin with no clinical response, serum and cerebral spinal fluid (CSF) concentrations of ivermectin were measured to assess absorption. The peak serum concentration of 49.3 ng/mL correlated with a CSF concentration of 0.14 ng/mL. Despite these concentrations, the patient eventually succumbed to multi-system organ failure. We discuss the reasons for treatment failure and explore the utility of measuring ivermectin concentrations.

scholarly journals E. coliMeningitis Presenting in a Patient with DisseminatedStrongyloides stercoralis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Juliana B. Gomez ◽  
Yvan Maque ◽  
Manuel A. Moquillaza ◽  
William E. Anicama
Keyword(s):  
Gastrointestinal Symptoms ◽  
Abdominal Distension ◽  
Strongyloides Stercoralis ◽  
The Body ◽  
Case Presentation ◽  
E Coli ◽  
History Of ◽  
Disseminated Strongyloidiasis ◽  
Proper Diagnosis ◽  
Cerebrospinal Fluid Culture

Introduction. SpontaneousEscherichia colimeningitis is an infrequent condition in adults and is associated with some predisposing factors, including severeStrongyloides stercoralis(SS) infections.Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of Peru and Brazil two decades ago, and who received prednisone due to Bell’s palsy for three weeks before admission, presented to the Emergency Department with diarrhea, fever, and hematochezia. A week after admission he developed drowsiness, meningeal signs, abdominal distension, and constipation. A cerebrospinal fluid culture showed extended spectrumβ-lactamase producingE. coli. A colonoscopy was performed and showed pancolitis. Three days after the procedure the patient became unstable and developed peritoneal signs. He underwent a laparotomy, which ended up in a total colectomy and partial proctectomy due to toxic megacolon. Three days later the patient died in the intensive care unit due to septic shock. Autopsy was performed and microscopic examination revealed the presence of multipleStrongyloideslarvae throughout the body.Conclusion.Strongyloides stercoralisinfection should be excluded in adults with spontaneousE. colimeningitis, especially, if gastrointestinal symptoms and history of travelling to an endemic area are present. Even with a proper diagnosis and management, disseminated strongyloidiasis has a poor prognosis.

scholarly journals A case of fatal disseminated strongyloidiasis accompanied with intestinal obstruction

2019 ◽  
Vol 2019 (10) ◽  
Author(s):  
Peyman Heydarian ◽  
Iraj Mobedi ◽  
Mohamad Ali Mohaghegh ◽  
Abozar Hosseini ◽  
Fatemeh Goudarzvand Chegini ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Signs And Symptoms ◽  
Strongyloides Stercoralis ◽  
Final Diagnosis ◽  
High Humidity ◽  
Important Message ◽  
Disseminated Strongyloidiasis ◽  
Endemic Areas

Abstract Strongyloides stercoralis is an endemic parasite in some regions including the tropical and subtropical areas with high humidity. Most infections are asymptomatic with nonspecific signs and symptoms, making the final diagnosis complicated. Here, we report a patient referred to our hospital with signs consistent with sepsis, intestine obstruction, which finally died with the diagnosis of strongyloidiasis. The patient was from northern parts of Iran which are considered as endemic areas for S. stercoralis. In conclusion, there is an important message in this history, i.e. physicians should be aware of specific and non-specific signs of strongyloidiasis especially in people living in endemic areas to make an accurate final diagnosis by proper clinical and paraclinical examinations.

Terminal ileum resection as a trigger for Strongyloides stercoralis hyperinfection and ensuing serial sepsis in a 37-year-old patient with complicated Crohnʼs disease: a case report

2018 ◽  
Vol 56 (04) ◽  
pp. 380-383 ◽  
Author(s):  
Mirjana Topić ◽  
Silvija Čuković-Čavka ◽  
Marko Brinar ◽  
Mirjana Kalauz ◽  
Ivica Škrlec ◽  
...  
Keyword(s):  
Terminal Ileum ◽  
Skin Penetration ◽  
Strongyloides Stercoralis ◽  
Developed Countries ◽  
Clinical Settings ◽  
Solid Organ ◽  
Transplant Patients ◽  
Skin Contact ◽  
Life Threatening ◽  
The Tropics

AbstractThe nematode Strongyloides stercoralis, outside the tropics and subtropics present in small endemic foci, can cause an infection after direct skin contact with contaminated soil containing infective filariform larvae and, rarely, after intimate interhuman contact or after transplantation of an infected solid organ. Following skin penetration, migration, and maturation through several stages, a small number of invasive filariform larvae can develop anew in the gut lumen, perpetuating new cycles of penetration, tissue migration, and reproduction, without leaving the host.In a state of immunosuppression, autoinfection can progress to life-threatening hyperinfection and/or infection disseminated through virtually any organ. In developed countries, the most frequently recognized risk for severe hyperinfection is corticosteroid therapy, but this has been also described in malnourished, alcoholic, cancer, and transplant patients. Due to the frequent need for immunosuppressive therapy, patients suffering from inflammatory bowel disease (IBD) are susceptible to develop overwhelming strongyloidiasis. Strongyloidiasis can be easily overlooked in clinical settings, and in many European regions there is poor insight into the epidemiological burden of this disease.We present a case of S. stercoralis hyperinfection that triggered 3 successive episodes of sepsis caused by pathogens of the gut flora in a young patient suffering from stenotic form of Crohn’s disease. S. stercoralis hyperinfection occurred in the corticosteroid-free period, shortly after resection of the terminal ileum, which was probably the trigger for the overwhelming course. The patient was successfully treated with 10-day albendazole therapy.

Lumps and Bumps in Children

1992 ◽  
Vol 13 (10) ◽  
pp. 371-378
Author(s):  
Thomas C. Putnam
Keyword(s):  
The Body ◽  
Clear Cut ◽  
Life Threatening ◽  
Subcutaneous Tissues

Many lesions involving the skin or subcutaneous tissues alarm parents and, often fearing cancer, they bring their child to a physician. Most lesions are benign and rarely life-threatening. The physician faces the problem of determining which characteristics suggest only observation of a lesion and which make biopsy necessary. Because many lesions have a predilection for certain areas of the body, this is a useful form of categorization (Table 1). On first inspection of a superficial lesion, several questions must be asked, including the known duration, change in size, presence of pain or other signs of inflammation, and any noted multiplicity. The examination includes an accurate measurement of the size and, most importantly, a determination of the level of the lesion. This will help establish the diagnosis and help to determine whether the possibility of malignancy exists. Essentially all lesions originating in the skin of children are benign. Some are obvious, such as a wart, while others may not be so clear-cut, especially if the epidermis is not altered in appearance. Upon palpation of a cutaneous mass, the skin does not move over the surface and puckers when the adjacent skin and tissues are compressed and elevated. If the skin moves freely over the mass, the nature of the lesion is not so readily apparent.

scholarly journals Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

2014 ◽  
Vol 20 (1) ◽  
pp. 35-39
Author(s):  
Cambrea Simona Claudia ◽  
Ilie Maria Margareta ◽  
Carp Dalia Sorina ◽  
Ionescu C.
Keyword(s):  
Necrotizing Fasciitis ◽  
Severe Disease ◽  
The Body ◽  
Group A Streptococci ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
The Right ◽  
Surgery Department ◽  
Short Time

ABSTRACT Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body), high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a favorable outcome.

scholarly journals On the question of the treatment of uterine blood tumors

2020 ◽  
Vol 11 (4) ◽  
pp. 403-417
Author(s):  
Gr. N. Egorov
Keyword(s):  
Blood Vessel ◽  
Whole Blood ◽  
Total Mass ◽  
Lymphatic System ◽  
Blood Clot ◽  
Abdominal Cavity ◽  
The Body ◽  
Long Time ◽  
Life Threatening

The abdominal cavity is, in essence, an appendage of the lymphatic system, therefore, it cannot represent a completely foreign container for the blood poured out here. Indeed, the observations of Virchow, Wintrich and others show that whole blood can remain in this cavity for a long time (several days) without undergoing clotting (Pashutin). In view of this fact, it is natural to expect, as is confirmed by experiments, that most of the blood that has entered the abdominal cavity has time to be absorbed before it begins to coagulate. If a part of it, which failed to be absorbed in time, undergoes clotting, then this does not represent any particular disturbances in the overall economy of blood, the blood clot is completely absorbed after preliminary disintegration (fat). In this sense, hemorrhage into the abdominal cavity is not life-threatening, since the blood does not disappear for the body, but soon again, almost entirely, enters the total mass of the blood vessel.

scholarly journals A modern approach to the combination treatment of allergic rhinitis

2018 ◽  
pp. 92-95
Author(s):  
S. A. Karpischenko ◽  
G. V. Lavrenova ◽  
E. I. Muratova
Keyword(s):  
Allergic Rhinitis ◽  
Disease Incidence ◽  
The Body ◽  
Bronchial Obstruction ◽  
Common Disease ◽  
Nasal Breathing ◽  
Modern Approach ◽  
Life Threatening ◽  
Adults And Children ◽  
Consistent Increase

Allergic rhinitis is a common disease that significantly worsens the patient’s quality of life. In some cases, the disease can be life threatening. Severe attacks of bronchial obstruction may occur in patients with allergic rhinitis. The widespread prevalence of allergic rhinitis in adults and children, consistent increase in disease incidence constitutes a great medical and social issue. Treatment for allergic rhinitis should be aimed at reaching increased remission duration, preventing the exacerbation of the disease and educating patients to maintain control over the symptoms of the disease. A challenge that otolaryngologists and allergists face is to restore nasal breathing in patients with allergic rhinitis. The updated approach to the challenge is to suggest treatment that takes into account the pathophysiological mechanisms that occur not only in the mucous membrane of the nasal cavity, but throughout the body, in particular, in the intestine.

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