Malabsorption syndromes in the tropics

2010 ◽  
pp. 2357-2360
Author(s):  
V.I. Mathan
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Cryptosporidium Parvum ◽  
Strongyloides Stercoralis ◽  
Malabsorption Syndromes ◽  
The Tropics ◽  
Capillaria Philippinensis

Causes of secondary malabsorption that are mainly prevalent in the tropics include (1) progressive wasting in people infected with HIV, which is known as ‘slim disease’; (2) various infections—protozoal (e.g. Gardia lamblia, Cryptosporidium parvum), helminthic (e.g Capillaria philippinensis, Strongyloides stercoralis), bacterial (Mycobacterium tuberculosis...

Malabsorption syndromes in the tropics

2020 ◽  
pp. 2916-2924
Author(s):  
Vineet Ahuja ◽  
Govind K. Makharia
Keyword(s):  
Symptomatic Relief ◽  
Epidemiological Data ◽  
Strongyloides Stercoralis ◽  
Tropical Sprue ◽  
Nutritional Deficiencies ◽  
Chronic Diarrhoea ◽  
Industrialized Countries ◽  
Malabsorption Syndromes ◽  
Immunoproliferative Small Intestinal Disease ◽  
The Tropics

Causes of secondary malabsorption that are most common in the tropics include (1) progressive wasting in people infected with HIV, which is known as ‘slim disease’; (2) various infections—protozoal (e.g. Giardia lamblia, Cryptosporidium parvum), helminthic (e.g. Capillaria philippinensis, Strongyloides stercoralis), and bacterial (Mycobacterium tuberculosis); (3) immunoproliferative small intestinal disease; and (4) hypolactasia. Coeliac disease and Crohn’s disease also occur. When patients with conditions that can cause secondary malabsorption are excluded, a group remains who have chronic diarrhoea, malabsorption, and its nutritional sequelae. This primary or idiopathic malabsorption syndrome is called ‘tropical sprue’, which occurs against the background of tropical enteropathy (describing the fact that the morphology of the mucosa of normal gut is different in tropical preindustrialized countries from that in temperate-zone industrialized countries). The aetiology of tropical sprue is not known: epidemiological data suggests an infective cause, but no causal agent has been identified. Presentation is typically with loose or watery stools lasting for several weeks or months, and with symptoms and signs of nutritional deficiency. Management involves symptomatic relief from diarrhoea, and correction of fluid and electrolyte abnormalities and nutritional deficiencies. Attempts at specific curative measures—folic acid and tetracyclines—are usually given for up to 6 months.

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.

scholarly journals Hemoptysis in the Immunocompromised Patient: Do Not Forget Strongyloidiasis

2019 ◽  
Vol 4 (1) ◽  
pp. 35 ◽  
Author(s):  
Prakash Shrestha ◽  
Sean E. O’Neil ◽  
Barbara S. Taylor ◽  
Olaoluwa Bode-Omoleye ◽  
Gregory M. Anstead
Keyword(s):  
Developing Countries ◽  
Differential Diagnosis ◽  
Immunocompromised Patient ◽  
Strongyloides Stercoralis ◽  
Immunocompromised Patients ◽  
Secondary Infections ◽  
Immunosuppressed Patients ◽  
Disseminated Strongyloidiasis ◽  
The Tropics ◽  
Candida Pneumonia

Strongyloidiasis, due to infection with the nematode Strongyloides stercoralis, affects millions of people in the tropics and subtropics. Strongyloides has a unique auto-infective lifecycle such that it can persist in the human host for decades. In immunosuppressed patients, especially those on corticosteroids, potentially fatal disseminated strongyloidiasis can occur, often with concurrent secondary infections. Herein, we present two immunocompromised patients with severe strongyloidiasis who presented with pneumonia, hemoptysis, and sepsis. Both patients were immigrants from developing countries and had received prolonged courses of corticosteroids prior to admission. Patient 1 also presented with a diffuse abdominal rash; a skin biopsy showed multiple intradermal Strongyloides larvae. Patient 1 had concurrent pneumonic nocardiosis and bacteremia with Klebsiella pneumoniae and Enterococcus faecalis. Patient 2 had concurrent Aspergillus and Candida pneumonia and developed an Aerococcus meningitis. Both patients had negative serologic tests for Strongyloides; patient 2 manifested intermittent eosinophilia. In both patients, the diagnosis was afforded by bronchoscopy with lavage. The patients were successfully treated with broad-spectrum antibiotics and ivermectin. Patient 1 also received albendazole. Strongyloidiasis should be considered in the differential diagnosis of hemoptysis in immunocompromised patients with possible prior exposure to S. stercoralis.

Imported Opisthorchis viverrini and parasite infections from Thai labourers in Taiwan

1993 ◽  
Vol 67 (2) ◽  
pp. 102-106 ◽  
Author(s):  
H. W. Peng ◽  
H. L. Chao ◽  
P. C. Fan
Keyword(s):  
Intestinal Parasites ◽  
Clonorchis Sinensis ◽  
Strongyloides Stercoralis ◽  
Opisthorchis Viverrini ◽  
Control Measures ◽  
Parasitic Infections ◽  
Concentration Method ◽  
Parasite Infections ◽  
Stool Samples ◽  
Capillaria Philippinensis

AbstractIn order to determine the prevalence of intestinal parasites among labourers from Thailand in Taiwan, the stool samples from 1364 Thai labourers were examined by the formalin-ether concentration method and 18·0% were found to be infected with one or more parasites. The infection rates of hookworm, Opisthorchis viverrini, Strongyloides stercoralis, Enterobius vermicularis, Ascaris lumbricoides, Hymenolepis nana, Capillaria philippinensis, Schistosoma japonicum, Echinostoma sp., Entamoeba coli, Giardia lamblia, and Entamoeba histolytica, were 7·6%, 7·0%, 3·2%, 0·5%, 0·3%, 0·1%, 0·1%, 0·l%,0·l%, 0·4%, 0·2%, and 0·1% respectively. The prevalence was highest among the 21–25 age group (24·8%). Among the 245 infected persons, 91% were infected with one parasite, 8% with two parasites and 1% with three parasites. The finding that parasitic infections are prevalent among Thai labourers demonstrates the need for control measures in foreign labourers in Taiwan and further studies to determine the susceptibility of O. viverrini to the snail hosts of Clonorchis sinensis.

Reducing Burden of Hookworm Disease in the Management of Upper Abdominal Pain in the Tropics

2003 ◽  
Vol 33 (3) ◽  
pp. 174-175 ◽  
Author(s):  
Chineme Michael Anyaeze
Keyword(s):  
Abdominal Pain ◽  
Cost Effective ◽  
Strongyloides Stercoralis ◽  
Male Ratio ◽  
Cost Effective Approach ◽  
Ancylostoma Duodenale ◽  
Upper Abdominal ◽  
A Prospective Study ◽  
The Tropics ◽  
Age Range

A prospective study of the stool samples of 129 rural patients with symptoms of upper abdominal pain, tenderness and indigestion was carried out from 2 February 1998 to 31 December 1998 and followed up to June 1999. The age range was 11–85 years, female: male ratio 2.4:1: 102 specimens were positive for helminths — Ancylostoma duodenale (hookworm) 80 (62%); Trichuris trichuria (threadworm) 12 (9.3%); Ascaris lumbricoides (large roundworm) 10 (7.76%); Strongyloides stercoralis three (2.3%); Taenia saginata (tapeworm) three (2.3%). The female: male ratio for hookworm was 3:1. Treatment with appropriate anthelminthic agents were given serially at each visit according to the result of faecal examination. At 6 months follow up 88 patients were free of symptoms, 60 of which were caused by helminths the hookworm group. Stool ‘test and treat’ strategy appears to be a cost-effective approach in the management of these patients.

scholarly journals Mycobacterium tuberculosis Coinfection Has No Impact on Plasmodium berghei ANKA-Induced Experimental Cerebral Malaria in C57BL/6 Mice

2015 ◽  
Vol 84 (2) ◽  
pp. 502-510 ◽  
Author(s):  
Jannike Blank ◽  
Jochen Behrends ◽  
Thomas Jacobs ◽  
Bianca E. Schneider
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Immune Responses ◽  
Cerebral Malaria ◽  
Plasmodium Berghei ◽  
Parasite Clearance ◽  
Human Infection ◽  
Experimental Cerebral Malaria ◽  
Content Type ◽  
Cell Responses ◽  
The Tropics

Cerebral malaria (CM) is the most severe complication of human infection withPlasmodium falciparum. The mechanisms predisposing to CM are still not fully understood. Proinflammatory immune responses are required for the control of blood-stage malaria infection but are also implicated in the pathogenesis of CM. A fine balance between pro- and anti-inflammatory immune responses is required for parasite clearance without the induction of host pathology. The most accepted experimental model to study human CM isPlasmodium bergheiANKA (PbANKA) infection in C57BL/6 mice that leads to the development of a complex neurological syndrome which shares many characteristics with the human disease. We applied this model to study the outcome ofPbANKA infection in mice previously infected withMycobacterium tuberculosis, the causative agent of tuberculosis. Tuberculosis is coendemic with malaria in large regions in the tropics, and mycobacteria have been reported to confer some degree of unspecific protection against rodentPlasmodiumparasites in experimental coinfection models. We found that concomitantM. tuberculosisinfection did not change the clinical course ofPbANKA-induced experimental cerebral malaria (ECM) in C57BL/6 mice. The immunological environments in spleen and brain did not differ between singly infected and coinfected animals; instead, the overall cytokine and T cell responses in coinfected mice were comparable to those in animals solely infected withPbANKA. Our data suggest thatM. tuberculosiscoinfection is not able to change the outcome ofPbANKA-induced disease, most likely because the inflammatory response induced by the parasite rapidly dominates in mice previously infected withM. tuberculosis.

Chemotherapy and immunity in opportunistic parasitic infections in AIDS

Parasitology ◽  
1992 ◽  
Vol 105 (S1) ◽  
pp. S93-S101 ◽  
Author(s):  
A. Zumla ◽  
S. L. Croft
Keyword(s):  
Pneumocystis Carinii ◽  
Strongyloides Stercoralis ◽  
Scientific Data ◽  
Convincing Evidence ◽  
Parasitic Infections ◽  
Parasitic Diseases ◽  
Dependent Component ◽  
Parasite Infections ◽  
Immunodeficiency Syndrome ◽  
The Tropics

SUMMARYParasitic diseases are endemic in parts of the tropics, but there is no convincing evidence that their prevalence or incidence is increasing due to the HIV epidemic. Available scientific data on parasitic infections in patients with the Acquired Immunodeficiency Syndrome (AIDS) suggests a predominance of Pneumocystis carinii, Toxoplasma gondii and Cryptosporidium spp. For reasons which are unclear, parasitic infections such as Plasmodium falciparum, Strongyloides stercoralis and Entamoeba histolytica, where cell-mediated immune responses are also thought to be significant, do not appear to be opportunists of importance. It is being increasingly recognized that chemotherapy for parasitic diseases has a host-dependent component, although scientific data on this subject remain scanty. The management of opportunistic parasitic infections in patients infected with HIV is dogged by failures and relapses, aptly illustrating the notion of the relationship between chemotherapy and the immune response. This review discusses the immunity and chemotherapy of opportunistic parasite infections in patients infected with the Human Immunodeficiency Virus (HIV).

scholarly journals Modulation of Mycobacterium tuberculosis-specific humoral immune responses is associated with Strongyloides stercoralis co-infection

2017 ◽  
Vol 11 (5) ◽  
pp. e0005569 ◽  
Author(s):  
Rajamanickam Anuradha ◽  
Saravanan Munisankar ◽  
Yukti Bhootra ◽  
Chandrakumar Dolla ◽  
Paul Kumaran ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Immune Responses ◽  
Strongyloides Stercoralis ◽  
Humoral Immune ◽  
Humoral Immune Responses

scholarly journals Parásitos intestinales en habitantes de una comunidad rural del Estado Bolívar, Venezuela

2006 ◽  
Vol 17 (4) ◽  
pp. 259-268 ◽  
Author(s):  
Rodolfo Devera ◽  
Verónica Angulo ◽  
Ernesto Amaro ◽  
Miguel Finali ◽  
Gabriela Franceschi ◽  
...  
Keyword(s):  
Cryptosporidium Parvum ◽  
Ascaris Lumbricoides ◽  
Strongyloides Stercoralis ◽  
Trichuris Trichiura ◽  
Blastocystis Hominis ◽  
Cyclospora Cayetanensis ◽  
Sobre Todo

Introducción. Las parasitosis intestinales constituyen un importante problema de salud pública por sus altas tasas de prevalencia y amplia distribución mundial, sobre todo en las regiones tropicales y subtropicales, siendo la población infantil la mayormente afectada. Objetivo. Determinar la prevalencia de parásitos intestinales en habitantes de Aripao, comunidad rural del estado Bolívar, Venezuela. Materiales y Métodos. En abril de 2005 se realizó un estudio transversal con 155 habitantes de ambos sexos. De cada uno se obtuvo una muestra fecal la cual fue analizada mediante la técnica de examen directo, métodos de concentración de Kato y formol-éter, cultivo en placa de agar y coloración de Kinyoun. Resultados. La prevalencia de parasitosis intestinal fue de 83.9% (130/155). Las prevalencias por grupos de edad fueron similares (χ2 = 3.037; g.l. = 5). Ambos sexos fueron afectados por igual (p › 0.05). Se diagnosticaron 15 especies de parásitos y/o comensales. Los protozoarios fueron más prevalentes que los helmintos. Blastocystis hominis fue el parásito intestinal más prevalente con 60%. Se diagnosticaron 9 casos de Cryptosporidium parvum y 2 de Cyclospora cayetanensis. Entre los helmintos Ascaris lumbricoides (20%), Trichuris trichiura (9%) y Strongyloides stercoralis (4.5%) resultaron los más comunes. De los parasitados 75.4% resultó poliparasitado (98/130). En este último grupo los parásitos más frecuentemente asociados fueron Blastocystis hominis (75.5%) y Entamoeba coli (48.9%). Conclusión. Se determinó una elevada prevalencia (83.9%) de parásitos intestinales en habitantes de la comunidad rural de Aripao, estado Bolívar, Venezuela, sin predilección por el sexo o la edad y con predominio de los protozoarios, en particular de B. hominis.

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