scholarly journals 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

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.

scholarly journals Ivermectin treatment for Strongyloides infection in patients with COVID-19

2021 ◽  
Vol 47 (7/8) ◽  
pp. 316-321
Author(s):  
Keyword(s):  
At Risk ◽  
Strongyloides Stercoralis ◽  
Parasitic Infections ◽  
Evidence Based ◽  
Ivermectin Treatment ◽  
Inappropriate Use ◽  
Hyperinfection Syndrome ◽  
Disseminated Disease ◽  
Immunomodulatory Therapies ◽  
To Receive

Ivermectin, an antiparasitic agent, is not recommended for prophylaxis or treatment of coronavirus disease 2019 (COVID-19). Inappropriate use of ivermectin for treatment of COVID-19 may make it less available for patients with serious parasitic infections who could benefit from its use and worsen the current shortage of ivermectin in Canada. However, patients with COVID-19 who are candidates to receive immunomodulatory therapies (e.g. corticosteroids and interleukin-6 inhibitors) may be at risk of hyperinfection syndrome and disseminated disease from Strongyloides stercoralis. These complications can be severe and even fatal. It is important to recognize and screen patients who may be at risk of strongyloidiasis, as these patients may require treatment with ivermectin to avoid the potential for a hyperinfection syndrome and disseminated disease, which is frequently deadly. Clinicians should follow evidence-based recommendations to screen and treat for Strongyloides infection in patients with COVID-19 who are under consideration to receive specific COVID-19 therapies that alter immune response and may lead to hyperinfection syndrome or disseminated disease.

scholarly journals Fatal Strongyloides stercoralis hyperinfection syndrome in an alcoholic diabetic patient from México

Biomédica ◽  
2020 ◽  
Vol 40 (Supl. 1) ◽  
pp. 32-36
Author(s):  
Elba G. Rodríguez-Pérez ◽  
Alma Y. Arce-Mendoza ◽  
Roberto Saldívar-Palacios ◽  
Kevin Escandón-Vargas
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Patient ◽  
Strongyloides Stercoralis ◽  
Late Diagnosis ◽  
Diagnosis And Treatment ◽  
Medical Emergency ◽  
Immunocompromised Patients ◽  
Hyperinfection Syndrome ◽  
High Level

Strongyloides stercoralis hyperinfection syndrome is a medical emergency that requires a high level of suspicion. Immunocompromised patients are at high risk of hyperinfection syndrome; however, malnutrition, alcoholism, and diabetes mellitus also need to be considered as predisposing factors. The diagnosis and treatment of Strongyloides hyperinfection are challenging and patients often have severe complications. Consequently, mortality is overwhelmingly high, with proportions above 60%.Herein, we report a case of Strongyloides hyperinfection in a 40-year-old alcoholic diabetic patient living in México. Unfortunately, the late diagnosis resulted in his death despite the treatment and supportive measures. Increased awareness is needed to prevent the dire consequences of strongyloidiasis.

Cutaneous Strongyloides Infection Postchemotherapy

2016 ◽  
Vol 20 (4) ◽  
pp. 337-339 ◽  
Author(s):  
Erica Merman ◽  
Sanjay Siddha ◽  
Jay S. Keystone ◽  
Ayman Al Habeeb ◽  
Danny Ghazarian ◽  
...  
Keyword(s):  
Skin Biopsy ◽  
Clinical Symptoms ◽  
Immunocompromised Patient ◽  
Diagnosis And Treatment ◽  
Larva Currens ◽  
Increased Risk ◽  
Hyperinfection Syndrome ◽  
Disseminated Disease

Background and Objective: While clinical symptoms of strongyloidiasis are often nonspecific, larva currens (with erythematous, serpiginous, and pruritic papules and plaques) should prompt investigation including stool microscopy, serology, and skin biopsy of the lesion. Appropriate diagnosis and treatment with ivermectin is necessary, especially in the immunocompromised patient who is at increased risk for hyperinfection syndrome and disseminated disease. Conclusion: We present a 61-year-old immunocompromised man with presentation of larva currens of cutaneous strongyloides infection without symptoms of hyperinfection or disseminated disease.

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 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.

A cluster-controlled clinical trial of two prophylactic silicone sacral dressings to prevent sacral pressure injuries in critically ill patients

2019 ◽  
pp. 21-26 ◽  
Author(s):  
Monica Stankiewicz ◽  
Jodie Gordon ◽  
Joel Dulhunty ◽  
Wendy Brown ◽  
Hamish Pollock ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care ◽  
Similar Efficacy ◽  
Care Patient ◽  
Controlled Clinical Trial ◽  
Cost Difference ◽  
Increased Risk ◽  
Pressure Injury ◽  
Risk Patients ◽  
The Mean

Objective Patients in the intensive care unit (ICU) have increased risk of pressure injury (PI) development due to critical illness. This study compared two silicone dressings used in the Australian ICU setting for sacral PI prevention. Design A cluster-controlled clinical trial of two sacral dressings with four alternating periods of three months' duration. Setting A 10-bed general adult ICU in outer-metropolitan Brisbane, Queensland, Australia. Participants Adult participants who did not have a sacral PI present on ICU admission and were able to have a dressing applied for more than 24 hours without repeated dislodgement or soiling in a 24-hour period (>3 times). Interventions Dressing 1 (Allevyn Gentle Border Sacrum™, Smith & Nephew) and Dressing 2 (Mepilex Border Sacrum™, Mölnlycke). Main outcomes measures The primary outcome was the incidence of a new sacral PI (stage 1 or greater) per 100 dressing days in the ICU. Secondary outcomes were the mean number of dressings per patient, the cost difference of dressings to prevent a sacral PI and product integrity. Results There was no difference in the incidence of a new sacral PI (0.44 per 100 dressing days for both products, p = 1.00), the mean number of dressings per patient per day (0.50 for both products, p = 0.51) and product integrity (85% for Dressing 1 and 84% for Dressing 2, p = 0.69). There was a dressing cost difference per patient (A$10.29 for Dressing 1 and A$28.84 for Dressing 2, p < 0.001). Conclusions Similar efficacy, product use and product integrity, but differential cost, were observed for two prophylactic silicone dressings in the prevention of PIs in the intensive care patient. We recommend the use of sacral prophylactic dressings for at-risk patients, with the choice of product based on ease of application, clinician preference and overall cost-effectiveness of the dressing.

Biochemical Markers in Patients with Readmission for Congestive Heart Failure

2018 ◽  
Vol 69 (7) ◽  
pp. 1687-1691
Author(s):  
Razan Al Namat ◽  
Mihai Constantin ◽  
Ionela Larisa Miftode ◽  
Andrei Manta ◽  
Antoniu Petris ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Rural Areas ◽  
Discharge Planning ◽  
Difficult Problem ◽  
Uncontrolled Hypertension ◽  
Medical Attention ◽  
Family Doctors ◽  
Increased Risk ◽  
Risk Patients

Repetitive or recurrent hospitalizations are a general major health issue in patients with chronic disease. Congestive heart failure, is associated with a high incidence and presence of early rehospitalization, but variables in order to identify patients at increased risk and also an analysis of potentially remediable factors contributing to readmission have not been previously reported and it remains still a difficult problem. We retrospectively assessed 100 patients aged between 48-85 years old, of which 75% were men, who had been hospitalized with documentation of congestive heart failure in St. Spiridon County Emergency Hospital. They were hospitalized between 2010-2017. Even if recurrent heart failure was the most common cause for readmission or rehospitalization, other cardiac disorders and noncardiac illnesses were also accounted for readmission. Predictive factors of an increased probability of readmission included prior patient�s medical heart failure history, heart failure decompensation precipitated or accelerated by an ischaemic episode, atrial fibrillation or uncontrolled hypertension. Factors contributing to preventable readmissions included noncompliance with medications or diet, inadequate discharge planning or follow-up, failure of both social support system and the seek of a promp medical attention when symptoms reappeared. We also identified an inappropriate colaboration with family doctors especially for the patients from rural areas. Patients were more likely to cite side effects of prescribed medications rather than nonadherence as a precipitating factor for readmission. Thus, we can appreciate that early rehospitalization in patients with congestive heart failure may be avoidable in up to 50% of cases. Identification of high risk patients is possible and also necessary shortly after admission in order to identify nonpharmacological interventions designed to decrease readmission frequency.

Cardiovascular Disease in Spondyloarthritides

2020 ◽  
Vol 18 (5) ◽  
pp. 473-487 ◽  
Author(s):  
Charalampos Papagoras ◽  
Paraskevi V. Voulgari ◽  
Alexandros A. Drosos
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Healthcare Providers ◽  
Cardiovascular Death ◽  
Point Of View ◽  
Treat To Target ◽  
Inflammatory Joint Diseases ◽  
Scientific Organizations ◽  
Increased Risk ◽  
Risk Patients

The spondyloarthritides are a group of chronic systemic inflammatory joint diseases, the main types being ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Evidence accumulating during the last decades suggests that patients with AS or PsA carry an increased risk for cardiovascular disease and cardiovascular death. This risk appears to be mediated by systemic inflammation over and above classical cardiovascular risk factors. The excess cardiovascular risk in those patients has been formally acknowledged by scientific organizations, which have called physicians’ attention to the matter. The application by Rheumatologists of new effective anti-rheumatic treatments and treat-to-target strategies seems to benefit patients from a cardiovascular point of view, as well. However, more data are needed in order to verify whether anti-rheumatic treatments do have an effect on cardiovascular risk and whether there are differences among them in this regard. Most importantly, a higher level of awareness of the cardiovascular risk is needed among patients and healthcare providers, better tools to recognize at-risk patients and, ultimately, commitment to address in parallel both the musculoskeletal and the cardiovascular aspect of the disease.

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