Immunocompromised patient with strongyloidosis
Keywords:
parasitosis, corticosteroid therapy, immunosuppression, endogenous reinfection, hyperinfection syndromeAbstract
Background: Strongyloidosis is a parasitosis caused by a nematode Strongyloides stercoralis. It is endemic in tropical and subtropical regions, but rarely encountered in temperate areas. Most patients present with non-specific symptoms or they have no symptoms. The disease evolves into hyperinfection syndrome or disseminated disease in immunocompromised patients characterized by high mortality rates. Early diagnosis and effective treatment are of major importance. Drugs such as mebendazol and albendazol are used in therapy. Antibiotics are used for possible concurrent bacterial infections.
Patient and the methods: We present the case of a 73-year-old woman who has chronic obstructive pulmonary disease receiving corticosteroid therapy. She was complaining about chronic abdominal discomfort characterized by intermittent diarrhoea and constipation. Occasionally, she was presenting with red rash. The laboratory findings: eosinophilia, anemia and a positive hematest in a stool specimen. The eggs and larvae of the parasite were identified by the procedures of biopsy and histological examination of duodenal mucosa. The parasite was found in sputum, too – the proof of the invasion into the lungs.
Conclusions: The patient was treated with mebendazol and albendazol. The examination of successive stool and sputum specimens after the treatment showed no eggs or larvae.
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