scholarly journals Human infection withStrongyloides stercoralisand other related Strongyloides species

Parasitology ◽  
2016 ◽  
Vol 144 (3) ◽  
pp. 263-273 ◽  
Author(s):  
THOMAS B. NUTMAN
Keyword(s):  
Immune Responses ◽  
Immune Status ◽  
Treatment Options ◽  
Strongyloides Stercoralis ◽  
Human Infection ◽  
Molecular Tests ◽  
Intestinal Nematode ◽  
Hyperinfection Syndrome ◽  
Asymptomatic Infections ◽  
And Control

SUMMARYThe majority of the 30–100 million people infected withStrongyloides stercoralis, a soil transmitted intestinal nematode, have subclinical (or asymptomatic) infections. These infections are commonly chronic and longstanding because of the autoinfective process associated with its unique life cycle. A change in immune status can increase parasite numbers, leading to hyperinfection syndrome, dissemination, and death if unrecognized. Corticosteroid use and HTLV-1 infection are most commonly associated with the hyperinfection syndrome.Strongyloidesadult parasites reside in the small intestine and induce immune responses both local and systemic that remain poorly characterized. Definitive diagnosis ofS. stercoralisinfection is based on stool examinations for larvae, but newer diagnostics – including new immunoassays and molecular tests – will assume primacy in the next few years. Although good treatment options exist for infection and control of this infection might be possible,S. stercoralisremains largely neglected.

scholarly journals Strongyloides hyperinfection syndrome, Cytomegalovirus enteritis with viremia and recurrent gram-negative sepsis in a patient with recurrent thymoma: a case report

2021 ◽  
Vol 9 (4) ◽  
pp. 1212
Author(s):  
Rama Narasimhan ◽  
Neetu Mariam Alex ◽  
Phani Machiraju ◽  
Meera Shankar
Keyword(s):  
Strongyloides Stercoralis ◽  
Severe Form ◽  
Immunosuppressed Patient ◽  
Myasthenic Crisis ◽  
Intravenous Ganciclovir ◽  
Gram Negative ◽  
Multiple Risk Factors ◽  
Intestinal Nematode ◽  
Hyperinfection Syndrome ◽  
High Index Of Suspicion

Strongyloides stercoralis is an intestinal nematode which is endemic in tropical and subtropical countries.  It may cause asymptomatic infections, mild eosinophilia or hyperinfection syndrome in the most severe form. We are reporting a case of Strongyloides hyperinfection syndrome in an immunosuppressed patient with recurrent thymoma and myasthenic crisis. This patient is a 51-year-old man with myasthenia gravis on long term pyridostigmine and prednisolone and mycophenolate. He presented with copious diarrhoea and was in septic shock. His blood and urine cultures grew Klebsiella pneumoniae and Pseudomonas aeruginosa. Oesophago-gastro-duodenoscopy (OGD scopy) and biopsy showed severe active duodenitis with strongyloidiasis and moderate active antral gastritis with strongyloidiasis. He was diagnosed to have Strongyloides hyperinfection and was treated with oral Ivermectin. He recovered well. He was subsequently diagnosed to have CMV enteritis with viraemia and was treated with intravenous Ganciclovir. Our case emphasizes the association of Strongyloides hyperinfection with superimposed CMV infection and gram-negative sepsis due to prolonged immunosuppression and autoimmunity in Thymoma patients. Recurrent thymoma and high-grade infiltrative thymoma often poses difficulty in the management of myasthenia patients. A high index of suspicion and aggressive treatment is paramount in approaching a patient with multiple risk factors of hyperinfection syndrome and autoimmunity. This case is reported in view of its rarity and significance regarding the multidisciplinary approach in decreasing morbidity and mortality in hyperinfection syndrome with an autoimmune background.

scholarly journals Strongyloides stercoralis in the Immunocompromised Population

2004 ◽  
Vol 17 (1) ◽  
pp. 208-217 ◽  
Author(s):  
Paul B. Keiser ◽  
Thomas B. Nutman
Keyword(s):  
Hematologic Malignancy ◽  
Clinical Manifestations ◽  
Parasite Burden ◽  
Strongyloides Stercoralis ◽  
Glucocorticoid Treatment ◽  
T Lymphotropic Virus ◽  
Intestinal Nematode ◽  
Increased Risk ◽  
Hyperinfection Syndrome ◽  
And Migration

SUMMARY Strongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. S. stercoralis is unique among intestinal nematodes in its ability to complete its life cycle within the host through an asexual autoinfective cycle, allowing the infection to persist in the host indefinitely. Under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome, characterized by increased numbers of infective filariform larvae in stool and sputum and clinical manifestations of the increased parasite burden and migration, such as gastrointestinal bleeding and respiratory distress. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment and human T-lymphotropic virus type 1 infection are the two conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelmintic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome as well as for primary and secondary prevention of hyperinfection in patients whose exposure history and underlying condition put them at increased risk.

scholarly journals Strongyloidiasis in the gastrointestinal biopsy

Pulse ◽  
1970 ◽  
Vol 3 (1) ◽  
pp. 27-28
Author(s):  
A Khaled ◽  
N Ara ◽  
LL Chawdhury ◽  
TA Nasir
Keyword(s):  
Strongyloides Stercoralis ◽  
Precise Estimate ◽  
Stool Examination ◽  
Disseminated Infection ◽  
Human Host ◽  
Infective Larvae ◽  
Intestinal Nematode ◽  
Hyperinfection Syndrome ◽  
Detection And Diagnosis

Strongyloides stercoralis is an intestinal nematode of humans. It is estimated that tens of millions of persons are infected worldwide, although no precise estimate is available [1].S. stercoralis is distinguished by its ability-unusual among helminths-to replicate in the human host. This capacity permits ongoing cycles of autoinfection as infective larvae are internally produced. Strongyloides can thus persist for decades without further exposure of the host to exogenous infective larvae [2]. Most infected individuals are asymptomatic, but under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome and disseminated infection [3]. Diagnosis of Strongyloides stercoralis is usually made by stool examination. Detection and diagnosis of strongyloidiasis in the gastrointestinal biopsy is relatively rare [4].DOI: 10.3329/pulse.v3i1.6551Pulse Vol.3(1) July 2009 p27-28

scholarly journals Strongyloides stercoralis Infestation in a Child: How a Nematode Can Affect Gut Microbiota

2021 ◽  
Vol 22 (4) ◽  
pp. 2131
Author(s):  
Stefania Pane ◽  
Anna Sacco ◽  
Andrea Iorio ◽  
Lorenza Romani ◽  
Lorenza Putignani
Keyword(s):  
Gut Microbiota ◽  
Bacterial Species ◽  
Alpha Diversity ◽  
Strongyloides Stercoralis ◽  
Pulmonary Involvement ◽  
Diversity Indices ◽  
Parasite Infection ◽  
Intestinal Nematode ◽  
Immune Mediated ◽  
Stool Samples

Background: Strongyloidiasis is a neglected tropical disease caused by the intestinal nematode Strongyloides stercoralis and characterized by gastrointestinal and pulmonary involvement. We report a pediatric case of strongyloidiasis to underline the response of the host microbiota to the perturbation induced by the nematode. Methods: We performed a 16S rRNA-metagenomic analysis of the gut microbiota of a 7-year-old female during and after S. stercolaris infection, investigating three time-point of stool samples’ ecology: T0- during parasite infection, T1- a month after parasite infection, and T2- two months after parasite infection. Targeted-metagenomics were used to investigate ecology and to predict the functional pathways of the gut microbiota. Results: an increase in the alpha-diversity indices in T0-T1 samples was observed compared to T2 and healthy controls (CTRLs). Beta-diversity analysis showed a shift in the relative abundance of specific gut bacterial species from T0 to T2 samples. Moreover, the functional prediction of the targeted-metagenomics profiles suggested an enrichment of microbial glycan and carbohydrate metabolisms in the T0 sample compared with CTRLs. Conclusions: The herein report reinforces the literature suggestion of a putative direct or immune-mediated ability of S. stercolaris to promote the increase in bacterial diversity.

scholarly journals Role for CD4+ CD25+ Regulatory T Cells in Reactivation of Persistent Leishmaniasis and Control of Concomitant Immunity

2004 ◽  
Vol 200 (2) ◽  
pp. 201-210 ◽  
Author(s):  
Susana Mendez ◽  
Stacie K. Reckling ◽  
Ciriacco A. Piccirillo ◽  
David Sacks ◽  
Yasmine Belkaid
Keyword(s):  
Immune Responses ◽  
Leishmania Major ◽  
Parasite Clearance ◽  
Effector Memory ◽  
Memory Response ◽  
Secondary Challenge ◽  
Concomitant Immunity ◽  
Disease Reactivation ◽  
And Control ◽  
Parasite Leishmania

Reactivation of dormant infections causes an immense burden of morbidity and mortality in the world at large. Reactivation can occur as a result of immunosuppression, environmental insult, or aging; however, the cause of reactivation of such infections is often not clear. We have previously shown that persistence of the parasite Leishmania major is controlled by endogenous CD4+ CD25+ regulatory T (T reg) cells. In this report, we show that despite efficient parasite clearance at secondary sites of infection, Leishmania superinfection can cause disease reactivation at the primary site. Our results strongly suggest that T reg cells, whose numbers increase in sites of reactivation, are directly responsible for such reactivation. Depletion of CD25+ cells at the time of secondary challenge prevented disease reactivation at the site of persistent infection while strengthening the expression of immunity at the site of secondary challenge. Finally, transfer of T reg cells purified from infected mice into chronically infected mice was sufficient to trigger disease reactivation and prevent the expression of an effector memory response. Our results demonstrate that after persistence is achieved, an equilibrium between T reg cells and effector lymphocytes, which can be disturbed by superinfection, controls the efficiency of recall immune responses and disease reactivation.

Pathogenesis of Gram-Negative Bacteremia

2021 ◽  
Vol 34 (2) ◽  
Author(s):  
Caitlyn L. Holmes ◽  
Mark T. Anderson ◽  
Harry L. T. Mobley ◽  
Michael A. Bachman
Keyword(s):  
Immune Responses ◽  
Global Economy ◽  
Human Infection ◽  
Model Systems ◽  
Small Subset ◽  
Gram Negative ◽  
Content Type ◽  
Capsule Production ◽  
Gram Negative Bacteremia ◽  
Species Specific

SUMMARY Gram-negative bacteremia is a devastating public health threat, with high mortality in vulnerable populations and significant costs to the global economy. Concerningly, rates of both Gram-negative bacteremia and antimicrobial resistance in the causative species are increasing. Gram-negative bacteremia develops in three phases. First, bacteria invade or colonize initial sites of infection. Second, bacteria overcome host barriers, such as immune responses, and disseminate from initial body sites to the bloodstream. Third, bacteria adapt to survive in the blood and blood-filtering organs. To develop new therapies, it is critical to define species-specific and multispecies fitness factors required for bacteremia in model systems that are relevant to human infection. A small subset of species is responsible for the majority of Gram-negative bacteremia cases, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. The few bacteremia fitness factors identified in these prominent Gram-negative species demonstrate shared and unique pathogenic mechanisms at each phase of bacteremia progression. Capsule production, adhesins, and metabolic flexibility are common mediators, whereas only some species utilize toxins. This review provides an overview of Gram-negative bacteremia, compares animal models for bacteremia, and discusses prevalent Gram-negative bacteremia species.

scholarly journals Strongyloidosis Hyperinfection Syndrome in an HIV-Infected Patient: A Rare Manifestation of Immune Reconstitution Inflammatory Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Kartik Natrajan ◽  
Mahenderkumar Medisetty ◽  
Raviraj Gawali ◽  
Ajit Tambolkar ◽  
Divya Patel ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Immunocompromised Host ◽  
Strongyloides Stercoralis ◽  
Parasitic Infections ◽  
Infected Female ◽  
Resource Limited ◽  
Hyperinfection Syndrome ◽  
Advanced Hiv Disease ◽  
Inflammatory Syndrome

Parasitic infections such as Strongyloides stercoralis and HIV have been reported to coexist, particularly in resource-limited settings such as India. In an immunocompromised host, S. stercoralis can progress to strongyloidiasis hyperinfection syndrome (SHS). However, SHS is not common in patients with advanced HIV disease. Immune reconstitution inflammatory syndrome (IRIS) developing after initiation of antiretroviral therapy (ART) can target multiple pathogens including S. stercoralis. The authors present here a 46-year-old HIV-infected female who was recently diagnosed with HIV-1 infection, started ART, and developed SHS. Her upper GI endoscopy revealed severe gastroduodenitis, and X-ray chest showed extensive bilateral pneumonitis. We could identify S. stercoralis in induced sputum and duodenal biopsy. We could also identify gut inflammation to restrict invading parasites. After receiving antihelminthic therapy, she showed improvement, a course of events that fit the diagnosis of unmasking S. stercoralis IRIS.

scholarly journals Oral administration ofLactobacillus acidophilusinduces IL-12 production in spleen cell culture of BALB/c mice bearing transplanted breast tumour

2010 ◽  
Vol 104 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Mohammad Hossein Yazdi ◽  
Mohammad Mehdi Soltan Dallal ◽  
Zuhair Mohammad Hassan ◽  
Marzieh Holakuyee ◽  
Solmaz Agha Amiri ◽  
...  
Keyword(s):  
Immune Responses ◽  
Oral Administration ◽  
Transforming Growth Factor ◽  
Transforming Growth Factor Β ◽  
Breast Tumour ◽  
Delayed Type Hypersensitivity ◽  
Daily Consumption ◽  
Colony Forming Units ◽  
And Control ◽  
Tumour Transplantation

Lactic acid bacteria can affect the maturation of immune cells and their products not only in the gut but also on the systemic immune organs such as lymph nodes and spleen. In the present work, we studied the effects of oral administration ofLactobacillus acidophiluson the immune responses of BALB/c mice bearing transplanted breast tumour. Two groups of female inbred BALB/c mice, each containing nine mice as test and control, were used. TheL. acidophilusATCC4356 strain was inoculated in DeMan–Rogosa–Sharpe broth and cultivated for 24 h at 37°C. Then, it was collected by centrifugation, and was washed and suspended in PBS. Afterwards, 0·5 ml/d of this suspension, which contained 2·7 × 108 colony forming units/ml of bacteria, was orally administered to the mice by gavage, 14 d before tumour transplantation and 30 d after that with 3-d intervals. Similar to the test mice, the control mice received an equal volume of PBS. The results showed that oral administration ofL. acidophilusincreased the production of IL-12 (P < 0·05) and decreased the level of transforming growth factor β (P = 0·05) in the splenocyte culture. Moreover, the growth rate of tumour in the test mice decreased (P < 0·01), and the results of delayed-type hypersensitivity assay after 48 h were risen (P < 0·05) in comparison with the controls. Results suggest that daily consumption ofL. acidophiluscan improve the production of immunomodulatory cytokine IL-12 in the splenocyte culture, which was stimulated by tumour antigen in BALB/c mice bearing transplanted breast tumour. But further studies are needed to find out some other possible mechanisms of this effect.

Pulmonary Hyperinfection Syndrome with Strongyloides stercoralis

CHEST Journal ◽  
1990 ◽  
Vol 97 (6) ◽  
pp. 1475-1477 ◽  
Author(s):  
Edward Chu ◽  
Warren L. Whitlock ◽  
Robert A. Dietrich
Keyword(s):  
Strongyloides Stercoralis ◽  
Hyperinfection Syndrome
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