scholarly journals Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Muhammad Farhan Khaliq ◽  
Rayan E. Ihle ◽  
James Perry
Keyword(s):  
Respiratory Failure ◽  
Multidisciplinary Approach ◽  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Diagnostic Challenge ◽  
Travel History ◽  
Hyperinfection Syndrome ◽  
Factor Therapy ◽  
Low Prevalence ◽  
Necrosis Factor

Strongyloides stercoralis is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of Strongyloides hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF-α inhibitors. Despite aggressive treatment including broad-spectrum antibiotics and antihelminths, his respiratory failure worsened and he died after palliative extubation. S. stercoralis infection remains a diagnostic challenge. Presentation with Strongyloides is often nonspecific, and eosinophilia is absent in hyperinfection. Diagnosis can be delayed, especially in low-prevalence areas where suspicion is low. Strongyloides should be considered in the differential diagnosis in the presence of risk factors including immunosuppressive therapy, and a travel history should be carefully obtained. Patients with recurrent enterobacterial sepsis or respiratory failure with diffuse infiltrates in the setting of eosinophilia should undergo testing for Strongyloides. A multidisciplinary approach can result in earlier diagnosis and favorable outcomes.

scholarly journals Strongyloides stercoralis hyperinfection: an unusual cause of gastrointestinal bleeding

2015 ◽  
Vol 61 (4) ◽  
pp. 311-312 ◽  
Author(s):  
Juliana Trazzi Rios ◽  
Matheus Cavalcante Franco ◽  
Bruno da Costa Martins ◽  
Elisa Ryoka Baba ◽  
Adriana Vaz Safatle-Ribeiro ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Strongyloides Stercoralis ◽  
Pulmonary Involvement ◽  
Parasitic Disease ◽  
Diagnostic Challenge ◽  
Infective Larvae ◽  
Hyperinfection Syndrome ◽  
And Migration

SummaryStrongyloidiasis is a parasitic disease that may progress to a disseminated form, called hyperinfection syndrome, in patients with immunosuppression. The hyperinfection syndrome is caused by the wide multiplication and migration of infective larvae, with characteristic gastrointestinal and/or pulmonary involvement. This disease may pose a diagnostic challenge, as it presents with nonspecific findings on endoscopy.

scholarly journals Strongyloides stercoralis infestation in a pediatric patient

Bionatura ◽  
2021 ◽  
Vol 3 (3) ◽  
pp. 2046-2047
Author(s):  
Ricardo Rubio-Sánchez ◽  
Esperanza Lepe-Balsalobre
Keyword(s):  
Emergency Department ◽  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Developed Countries ◽  
Watery Diarrhea ◽  
Diagnostic Strategy ◽  
Parasitic Disease ◽  
Laboratory Studies ◽  
Abdominal Symptoms ◽  
Low Prevalence

Strongyloidiasis is a parasitic disease, very rare in countries like Spain, caused by the Strongyloides stercoralis nematode. We present a case of a 5-year-old patient from Ecuador who came to the Emergency Department due to fever, colicky abdominal pain, watery diarrhea, and occasional vomiting of several days of evolution. In laboratory studies, a marked leukocytosis with eosinophilia stands out, for which reason a microscopic study of the stool was carried out where larval forms compatible with Strongyloides stercoralis were observed. The diagnostic strategy of parasitic infection in developed countries is highly influenced by the low prevalence and diversity of the parasitic species, causing the diagnosis, on many occasions, to be a challenge. In the presence of eosinophilia and abdominal symptoms, it is recommended to orient the diagnosis towards a possible infection of parasitic origin to make an early diagnosis of the infection and avoid possible serious complications.

scholarly journals Common Presentation of an Uncommon DiseaseStrongyloidiasis could be Devastating in an Immunocompromised Host

2021 ◽  
Vol 2 (1) ◽  
pp. 47-49
Author(s):  
Mohammad Shohidul Islam
Keyword(s):  
Early Diagnosis ◽  
Immunocompromised Patient ◽  
Parasitic Infection ◽  
Immunocompromised Host ◽  
Strongyloides Stercoralis ◽  
Endoscopic Biopsy ◽  
Common Presentation ◽  
Hyperinfection Syndrome ◽  
Nonspecific Sign ◽  
Disseminated Disease

Strongyloidiasis is a chronic self-limited parasitic infection associated with mostly nonspecific sign symptoms. But in immunocompromised patient’s morbidity and mortality is high due to hyperinfection syndrome and disseminated disease. So early diagnosis is very important. Here we report a case of hyperinfection with Strongyloides stercoralis in an elderly immunocompromised patient diagnosed by endoscopic biopsy who was treated successfully later on. Keywords: Strongyloidiasis; parasitic infection; Immunocompromised host, Hyperinfection Disseminated disease

scholarly journals The Rheumatology Drugs for COVID-19 Management: Which and When?

2021 ◽  
Vol 10 (4) ◽  
pp. 783
Author(s):  
Fabiola Atzeni ◽  
Ignazio Francesco Masala ◽  
Javier Rodríguez-Carrio ◽  
Roberto Ríos-Garcés ◽  
Elisabetta Gerratana ◽  
...  
Keyword(s):  
English Language ◽  
Multidisciplinary Approach ◽  
Intravenous Immunoglobulins ◽  
Cochrane Library ◽  
Immunomodulatory Drugs ◽  
Antiviral Therapies ◽  
Tnf Α ◽  
Large Heterogeneity ◽  
Necrosis Factor ◽  
Game Changer

Introduction: While waiting for the development of specific antiviral therapies and vaccines to effectively neutralize the SARS-CoV2, a relevant therapeutic strategy is to counteract the hyperinflammatory status, characterized by an increase mainly of interleukin (IL)-1β, IL-2, IL-6, IL-7, IL-8, and tumor necrosis factor (TNF)-α, which hallmarks the most severe clinical cases. ‘Repurposing’ immunomodulatory drugs and applying clinical management approved for rheumatic diseases represents a game-changer option. In this article, we will review the drugs that have indication in patients with COVID-19, including corticosteroids, antimalarials, anti-TNF, anti-IL-1, anti-IL-6, baricitinib, intravenous immunoglobulins, and colchicine. The PubMed, Medline, and Cochrane Library databases were searched for English-language papers concerning COVID-19 treatment published between January 2020 and October 2020. Results were summarized as a narrative review due to large heterogeneity among studies. In the absence of specific treatments, the use of immunomodulatory drugs could be advisable in severe COVID-19 patients, but clinical outcomes are still suboptimal. An early detection and treatment of the complications combined with a multidisciplinary approach could allow a better recovery of these patients.

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