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.

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 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.

In Shortly about HIV and AIDS

2020 ◽  
Vol 2020 ◽  
Author(s):  
Sinisa Franjic
Keyword(s):  
Opportunistic Infections ◽  
Hiv And Aids ◽  
The Body ◽  
Hiv Disease ◽  
Infected Person ◽  
Defense System ◽  
Infected Mother ◽  
Unprotected Sexual Intercourse ◽  
Hiv Virus ◽  
Immunodeficiency Virus

HIV is a human immunodeficiency virus, a retrovirus that causes AIDS in the event of untreated infection. The virus causes the weakness and inability of the organism's defense system. HIV disease is a chronic progressive process that begins with the onset of HIV virus into the body, and over time (in adults over 10 years), a gradual destruction of the immune system occurs. The host during the infection becomes vulnerable and is suffering from complications of opportunistic infections and malignancies. A person infected with HIV feels good until developing AIDS, does not notice any changes in health, and has no specific external signs of infection. The only way to detect infection at this stage is HIV testing. HIV is transmitted: unprotected sexual intercourse with the infected person, exchange of needles, syringes or accessories with infected persons when taking drugs, with infected mother on her baby before, during or after delivery (breastfeeding).

Lymphangiomatosis of the Body Wall: A Report of Two Cases Associated with Chylothorax and Fatal Outcome

1997 ◽  
Vol 17 (4) ◽  
pp. 617-624 ◽  
Author(s):  
Philippe Moerman ◽  
Chris Van Geet ◽  
Hugo Devlieger
Keyword(s):  
Body Wall ◽  
Fatal Outcome ◽  
The Body

New Therapeutic Approach to Reduce Methotrexate Toxicity after High-Dose Chemotherapy in a Child with Acute Lymphocytic Leukemia: Efficacy and Safety of Hemoadsorption with HA-230 Adsorber

2021 ◽  
pp. 1-5
Author(s):  
Vitaliy Sazonov ◽  
Zaure Tobylbayeva ◽  
Askhat Saparov ◽  
Bolatbek Jubaniyazov ◽  
Samat Issakov ◽  
...  
Keyword(s):  
Acute Lymphocytic Leukemia ◽  
Pediatric Patients ◽  
High Dose Chemotherapy ◽  
The Body ◽  
Lymphocytic Leukemia ◽  
High Dose ◽  
Successful Implementation ◽  
Efficacy And Safety ◽  
Related Complication ◽  
Dose Methotrexate

Background: High-dose methotrexate (HDMTX) is likely to cause a number of side effects and manifest itself as hepatotoxicity, nephrotoxicity, mucositis, and neurotoxicity. A several studies demonstrated the efficacy of extracorporeal detoxification methods such as plasma exchange, hemodialysis (HD), HD filtration, and hemoperfusion for the treatment of MTX delayed clearance. However, none of the existing methods as effective as expected and limited for general implementation due to a procedure-related complication. Case Report: Here, we report a successful implementation of HA-230 hemoadsorption procedure to remove cumulated MTX from the body and reduce its toxicity in a child with ALL after high-dose chemotherapy. Results and Conclusion: Based on our results, single-hemoadsorption procedure with the HA-230 adsorber in case of delayed methotrexate clearance was safe and well-tolerated in a pediatric patient with ALL and would significantly improve the patient’s condition. Further studies need to demonstrate its safety and efficacy in a large number of pediatric patients.

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.

Lymphangiomatosis of the Body Wall: A Report of Two Cases Associated with Chylothorax and Fatal Outcome

1997 ◽  
Vol 17 (4) ◽  
pp. 617-624 ◽  
Author(s):  
Philippe Moerman ◽  
Chris Van Geet ◽  
Hugo Devlieger
Keyword(s):  
Body Wall ◽  
Fatal Outcome ◽  
The Body

Histopathology of Gastric and Duodenal Strongyloides stercoralis Locations in Fifteen Immunocompromised Subjects

2006 ◽  
Vol 130 (12) ◽  
pp. 1792-1798 ◽  
Author(s):  
Francesco Rivasi ◽  
Silvio Pampiglione ◽  
Renzo Boldorini ◽  
Loredana Cardinale
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Duodenal Mucosa ◽  
Gastric Ulcers ◽  
Immunocompromised Patients ◽  
Histologic Diagnosis ◽  
Immunodeficiency Virus ◽  
Gastric Biopsies ◽  
Duodenal Biopsies

Abstract Context.—Strongyloidiasis is a worldwide parasitic infection affecting approximately 75 million people. In Italy, it was more prevalent in the past among rural populations of irrigated areas. Objective.—To determine the histopathologic alterations of the gastric and duodenal mucosa associated with the presence of Strongyloides stercoralis parasites. Design.—Fifteen cases of strongyloidiasis were observed in immunocompromised patients during a recent 6-year period in Italy. S stercoralis was found histologically in gastric biopsies (10 cases), in a gastrectomy (1 case), and in duodenal biopsies (9 cases). In 5 cases the parasite was present both in gastric and duodenal biopsies. Four patients were affected by lymphoma, 2 by multiple myeloma, 2 by gastric carcinoma, 1 by chronic myeloid leukemia, 1 by sideroblastic anemia, 1 by colorectal adenocarcinoma, 1 by chronic idiopathic myelofibrosis, 1 by chronic gastritis, 1 by gastric ulcers, and 1 by rheumatoid arthritis in corticosteroid therapy. No patient was affected by human immunodeficiency virus infection. Strongyloidiasis was not clinically diagnosed. Results.—Histologic examination revealed several sections of S stercoralis larvae, many eggs, and some adult forms. All the parasites were located in the gastric and/or the duodenal crypts. Eosinophils infiltrating into the lamina propria were found in all cases; their intensity was correlated with the intensity of the infection. Conclusions.—Histologic diagnosis of strongyloidiasis must be taken into consideration when examining both gastric and duodenal biopsies in immunocompromised patients, to avoid the development of an overwhelming infection of the parasite, which is dangerous for the life of the patient.

scholarly journals Case Report: Successful Management of a Refractory Plasmablastic Lymphoma Patient With Tislelizumab and Lenalidomide

2021 ◽  
Vol 12 ◽  
Author(s):  
Lili Cheng ◽  
Qi Song ◽  
Mengke Liu ◽  
Yan Wang ◽  
Hongmei Yi ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Hematological Malignancy ◽  
Checkpoint Inhibitor ◽  
Immune Therapy ◽  
Case Series ◽  
The Elderly ◽  
Plasmablastic Lymphoma ◽  
Successful Management ◽  
Immunodeficiency Virus ◽  
Specific Standard

Plasmablastic lymphoma (PBL) is a rare and aggressive hematological malignancy. PBL commonly occurs in immune incompetent patients, such as those with human immunodeficiency virus (HIV), post-transplant status, or immunosenescence. Given its rarity, there is no specific standard treatment for PBL. However, small case series have shown that intensive chemotherapies combined with anti-myeloma agents such as bortezomib and lenalidomide were effective in treating PBL. Unfortunately, some fragile patients could not tolerate intensive chemotherapeutic regimens, especially the elderly patients. Here we presented a 76-year-old female PBL patient refractory to miniCHOP regimen combined with bortezomib but achieved complete remission when treated with tislelizumab combined with lenalidomide, indicating that immune therapy may be a potential treatment for PBL. To our knowledge, this is the first chemoresistant PBL patient that has been successfully treated with checkpoint inhibitor plus lenalidomide, thus providing new insight towards PBL management.

scholarly journals 336. COVID-19 and Pneumocystis jiroveci Pneumonia

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S272-S273
Author(s):  
Christopher Saling ◽  
Sabirah N Kasule ◽  
Holenarasipur R Vikram
Keyword(s):  
Opportunistic Infection ◽  
Patient Characteristics ◽  
Lymphocytic Leukemia ◽  
High Dose ◽  
Pneumocystis Jiroveci ◽  
Infection Age ◽  
Pneumocystis Jiroveci Pneumonia ◽  
Immunodeficiency Virus ◽  
Low Threshold ◽  
Mean Time

Abstract Background More accounts of opportunistic infection in COVID-19 patients are emerging. At our institution, we identified 2 COVID-19 patients with Pneumocystis jiroveci pneumonia (PJP) opportunistic infection. This prompted a review of the literature to identify trends in patient characteristics, risk factors, and outcomes in this population. Methods A literature review was conducted using PubMed that identified 13 other patients with both COVID-19 and PJP infection. Age, gender, human immunodeficiency virus (HIV) status, other immunocompromised states, time between COVID-19 and PJP diagnosis, and clinical outcomes were captured for analysis. Results Eleven patients were male. The average age was 56 years. All but 2 patients were immunocompromised. At time of PJP diagnosis, seven patients had newly diagnosed HIV and one had known, well-controlled HIV. One patient had rheumatoid arthritis receiving leflunomide, 1 had ulcerative colitis receiving budesonide and sulfasalazine, 2 patients had multiple myeloma whereby both were on lenalidomide, 1 patient was a renal transplant recipient immunosuppressed on tacrolimus, mycophenolate, and methylprednisolone, and 1 patient had chronic lymphocytic leukemia getting fludarabine, cyclophosphamide, and rituximab. Nine patients had positive COVID-19 and PJP tests performed within 7 days of one another. One patient tested positive for PJP 54 days into admission for COVID-19. This patient received high dose steroids and tocilizumab for initial COVID-19 infection. Three patients were re-hospitalized with PJP after a recent admission for COVID-19 pneumonia, with a mean time to readmission of 25 days. One of these 3 patients had no treatment for COVID-19, while 2 received steroids. Five of the total 15 patients (33%) died. Conclusion COVID-19 treatments with high dose steroids and tocilizumab can make patients vulnerable for opportunistic infection with PJP. Furthermore, COVID-19 is known to cause lymphopenia which may further increase this risk. A diagnosis of concomitant PJP can be especially challenging due to nearly identical radiographical findings. Serum beta-D glucan and HIV testing can be especially helpful in this situation, and there should be a low threshold for performing bronchoalveolar lavage. Disclosures All Authors: No reported disclosures

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