Latent Strongyloides stercoralis in an Asymptomatic Male With Chronic Peripheral Eosinophilia

Strongyloidiasis: The Cause of Multiple Gastrointestinal Ulcers in an Immunocompetent Individual

Case Reports in Medicine ◽

10.1155/2014/346256 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Shail Sheth ◽

Fady Asslo ◽

Rabih Hallit ◽

Raymund Sison ◽

Muhammad Afridi ◽

...

Keyword(s):

Eosinophil Count ◽

Acute Abdominal Pain ◽

Strongyloides Stercoralis ◽

Immunocompetent Patient ◽

Parasitic Disease ◽

Peripheral Eosinophilia ◽

Laboratory Examination ◽

Tropical Regions ◽

Immunocompetent Individual ◽

First Case

Strongyloidiasis is a common parasitic disease in tropical regions of the world. Infection withStrongyloides stercoralisusually remains asymptomatic with peripheral eosinophilia and uncontrolled growth. Consequently, immunocompromised individuals are at a higher risk of complications of this disease. We present a case of an immunocompetent patient whose complaint of acute abdominal pain was found to be due to gastric and duodenal ulcerations. Laboratory examination revealed significantly elevated absolute eosinophil count at 11,466/mm3(normal 0–700/mm3). The duodenal biopsy revealed parasitic ova and adult worms suggestive ofStrongyloides stercoralisnematode with increased eosinophils in the tissue. We report the first case of multiple gastric and duodenal ulcerations due toStrongyloides stercoralisin an immunocompetent patient. We suggest that the elevated eosinophil count played a central role in the pathogenesis.

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ACUTE AND CHRONIC STRONGYLOIDIASIS IN RUSSIAN TOURISTS TRAVELLED TO THAILAND, THE COAST OF BLACK SEA IN RUSSIA AND ABKHAZIA: PROBLEMS OF DIAGNOSIS AND TREATMENT. ANALYSIS OF CASES AND REVIEW

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40989 ◽

2017 ◽

Vol 22 (3) ◽

pp. 156-161

Author(s):

Aleksandr M. Bronshteyn ◽

L. V Fedyanina ◽

N. A Malyshev ◽

V. Ya Lashin ◽

S. V Burova ◽

...

Keyword(s):

Black Sea ◽

Strongyloides Stercoralis ◽

Abdominal Discomfort ◽

Peripheral Eosinophilia ◽

Increased Risk ◽

Hyperinfection Syndrome ◽

Risk Patients ◽

Treatment Analysis ◽

High Level ◽

Disseminated Disease

Cases of acute and chronic Strongyloides stercoralis are presented as tourists travelled to Thailand, the coast of Black sea in Russia and Abkhazia. A high level of clinical suspicion is required to make the diagnosis of strongyloidiasis in at-risk patients presenting with peripheral eosinophilia, unexplained intermittent diarrhea, abdominal discomfort and skin rashes. Owing to increased risk of developing disseminated disease or hyperinfection syndrome, early detection and treatment of strongyloidiasis are extremely important. Strongyloidiasis should be routinely investigated in patients with chronic diseases who will undergo immunosuppressive therapy. Ivermectin or thiabendazole currently is the treatment of choice which are more effective than albendazole.

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Strongyloides Hyperinfection Associated with Enterococcus faecalis Bacteremia, Meningitis, Ventriculitis and Gas-Forming Spondylodiscitis: A Case Report

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed5010044 ◽

2020 ◽

Vol 5 (1) ◽

pp. 44 ◽

Cited By ~ 1

Author(s):

Liang En Wee ◽

Su Wai Khin Hnin ◽

Zheyu Xu ◽

Lawrence Soon-U Lee

Keyword(s):

Enterococcus Faecalis ◽

Strongyloides Stercoralis ◽

Altered Mental Status ◽

Early Morning ◽

Peripheral Eosinophilia ◽

Imaging Evaluation ◽

Steroid Use ◽

Travel History ◽

History Of ◽

Stool Specimens

An elderly Singaporean male with no travel history was hospitalized for fever and altered mental status. Blood cultures grew Enterococcus faecalis, and given a preceding history of steroid use and peripheral eosinophilia, Strongyloides hyperinfection was suspected. Stool specimens were positive for Strongyloides stercoralis larvae over four days, and larvae were also isolated in an early morning nasogastric aspirate specimen prior to initiation of ivermectin. A cerebrospinal fluid examination was consistent with partially treated bacterial meningitis and ventriculitis was demonstrated on neuroimaging. In view of a persistent fever, a further imaging evaluation was performed, which demonstrated bilateral pneumonia as well as the unusual finding of gas-forming emphysematous spondylodiscitis and left psoas abscesses. Despite the early suspicion of Strongyloides hyperinfection, commencement of appropriate antibiotics and anti-helminthics, microbiological clearance of bacteremia as well as clearance of S. stercoralis from the stool, the patient still succumbed to infection and passed away 11 days after admission.

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Strongyloides Hyperinfection in a Renal Transplant Patient: Always Be on the Lookout

Case Reports in Infectious Diseases ◽

10.1155/2017/2953805 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Murtaza Mazhar ◽

Ijlal Akbar Ali ◽

Nelson Iván Agudelo Higuita

Keyword(s):

Renal Transplant ◽

Kidney Disease ◽

Renal Transplant Patient ◽

Transplant Patient ◽

Strongyloides Stercoralis ◽

The United States ◽

Stool Examination ◽

Peripheral Eosinophilia ◽

Adult Polycystic Kidney Disease ◽

Prisoner Of War

We present a case of a 71-year-old Vietnamese man with chronic kidney disease secondary to adult polycystic kidney disease. He had been a prisoner of war before undergoing a successful cadaveric renal transplant in the United States. He presented to clinic one year after the transplant with gross hematuria, productive cough, intermittent chills, and weight loss. Long standing peripheral eosinophilia of 600–1200/μL triggered further evaluation. A wet mount of stool revealedStrongyloides stercoralislarvae. A computed tomography (CT) of chest showed findings suggestive of extension of the infection to the lungs. The patient was treated with a three-week course of ivermectin with complete resolution of signs, symptoms, peripheral eosinophilia, and the positive IgG serology. Strongyloides infection in renal transplant patient is very rare and often presents with hyperinfection, associated with high mortality rates. The American Transplant Society recommends pretransplant screening with stool examination andStrongyloides stercoralisantibody in recipients and donors from endemic areas or with eosinophilia. It is imperative that healthcare professionals involved in the care of these individuals be cognizant of these recommendations as it is a very preventable and treatable entity.

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Strongyloidiasis: The Cause of Hypereosinophillia and Duodenal Ulcer in an Immunocompetent Individual

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v12i1.39980 ◽

2016 ◽

Vol 12 (1) ◽

pp. 109-111

Author(s):

Md Monirul Hoque ◽

Shuvojit Sen ◽

Md Nizam Uddin

Keyword(s):

Eosinophil Count ◽

Acute Abdominal Pain ◽

Armed Forces ◽

Strongyloides Stercoralis ◽

Immunocompetent Patient ◽

Weekly Dose ◽

Peripheral Eosinophilia ◽

Laboratory Examination ◽

Tropical Regions ◽

Medical College

Strongyloidiasis is a common parasitic disease in tropical and sub-tropical regions of the world. Infection with Strongyloides Stercoralis usually remains asymptomatic with peripheral eosinophilia and uncontrolled growth. Consequently, immunocompromised individuals are at a higher risk of complications of this disease. A case of an immunocompetent patient who had complaint of acute abdominal pain and was found to have duodenal ulceration. Laboratory examination revealed significantly elevated absolute eosinophil count at 17000/cmm (normal 0-500/cmm). The stool R/E revealed rhabtidiform larvae suggestive of Strongyloides stercoralis nematode. Endoscopy of upper GIT showed ulcer in duodenum. The patient was treated with weekly dose of Tab Albendazole for two weeks and after that peripheral eosinophilia count became normal. This study found that the elevated eosinophil count played a central role in the pathogenesis. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 109-111

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