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 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.

Prevalence and geographic distribution of haemophilia in Costa Rica

2010 ◽  
Vol 30 (S 01) ◽  
pp. S28-S31 ◽  
Author(s):  
J. Arroyo ◽  
L. Salazar-Sánchez ◽  
G. Jiménez-Cruz ◽  
P. Chaverri ◽  
E. Arrieta-Bolaños ◽  
...  
Keyword(s):  
Costa Rica ◽  
Survival Rates ◽  
Coagulation Factors ◽  
Developed Countries ◽  
Health Centers ◽  
Distribution Analysis ◽  
Distribution Maps ◽  
Immunodeficiency Virus ◽  
The Many ◽  
Low Prevalence

SummaryHaemophilia is the most frequent hereditary haemorrhagic illness and it is due to the deficiency of coagulation factors VIII (haemophilia A, HA) or IX (haemophilia B, HB).The prevalence of this disease varies according to the country, those having better survival rates having also higher prevalences. Specifically in Costa Rica, there are around 130 HA and 30 HB families. This study reports the prevalence and a spatial distribution analysis of both types of the disease in this country. The prevalence of haemophilia in this country is 7 cases per 100 000 men, for HA it is 6 cases per 100 000 and for HB it is 1 case per 100 000 male inhabitants. The prevalence of this disease is low when compared with other populations. This low prevalence could be due to the many patients that have died because of infection with human immunodeficiency virus during the 1980s. The prevalence of haemophilia in Costa Rica is almost one half of that present in developed countries. Nevertheless, the ratio between HA and HB follows world tendency: 5 : 1. In this study, nationwide geographical distribution maps were drawn in order to visualize the origin of severe cases and how this influences the pattern of distribution for both types of haemophilia. By means of these maps, it was possible to state that there is no association between the sites of maximum prevalence of mutated alleles and ethnicity. With this study, haemophilia prevalence distribution maps can be used to improve efforts for the establishment of hemophilia clinics or specialized health centers in those areas which hold the highest prevalences in this country. Also, this knowledge can be applied to improve treatment skills and offer the possibility of developing focused genetic counseling for these populations.

Chronic mesenteric ischaemia presenting as possible large bowl malignancy: an easily overlooked differential diagnosis

2021 ◽  
Vol 14 (3) ◽  
pp. e240202
Author(s):  
Benjamin McDonald
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Weight Loss ◽  
Differential Diagnosis ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Mesenteric Ischaemia ◽  
Abdominal Symptoms ◽  
Chronic Mesenteric Ischaemia ◽  
Descending Colon

An 80-year-old woman presented to a regional emergency department with postprandial pain, weight loss and diarrhoea for 2 months and a Computed Tomography (CT) report suggestive of descending colon malignancy. Subsequent investigations revealed the patient to have chronic mesenteric ischaemia (CMI) with associated bowel changes. She developed an acute-on-chronic ischaemia that required emergency transfer, damage control surgery and revascularisation. While the patient survived, this case highlights the importance of considering CMI in elderly patients with vague abdominal symptoms and early intervention to avoid potentially catastrophic outcomes.

scholarly journals Hookworm infection in infants: a case report and review of literature

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
G. Umbrello ◽  
R. Pinzani ◽  
A. Bandera ◽  
F. Formenti ◽  
G. Zavarise ◽  
...  
Keyword(s):  
Rural Areas ◽  
Simulation Models ◽  
Developed Countries ◽  
Hookworm Infection ◽  
Case Presentation ◽  
Abdominal Symptoms ◽  
Asymptomatic Children ◽  
Ancylostoma Duodenale ◽  
Stool Analysis ◽  
The Tropics

Abstract Background Hookworm infections (Necator americanus, Ancylostoma duodenale) are common in rural areas of tropical and subtropical countries. Human acquisition results from direct percutaneous invasion of infective larvae from contaminated soil. Overall, almost 472 million people in developing rural countries are infected. According to simulation models, hookworm disease has a global financial impact of over US$100 billion a year. Hookworm infection in newborn or infancy is rare, and most of the cases reported in literature are from endemic countries. Here, we describe the case of an infant with an Ancylostoma duodenale infection and review the literature currently available on this topic. Case presentation An Italian 2-month-old infant presented with vomit and weight loss. Her blood exams showed anemia and eosinophilia and stool analysis resulted positive for hookworms’ eggs, identified as Ancylostoma duodenale with real time-PCR. Parasite research on parents’ stools resulted negative, and since the mother travelled to Vietnam and Thailand during pregnancy, we assumed a transplacental transmission of the infection. The patient was treated successfully with oral Mebendazole and discharged in good conditions. Discussion Hookworm helminthiasis is a major cause of morbidity in children in the tropics and subtropics, but rare in developed countries. Despite most of the patients is usually asymptomatic, children are highly exposed to negative sequelae such as malnutrition, retarded growth and impaired cognitive development. In infants and newborns, the mechanism of infection remains unclear. Although infrequent, vertical transmission of larvae can occur through breastfeeding and transplacentally. Hookworm infection should be taken into account in children with abdominal symptoms and unexplained persistent eosinophilia. The treatment of infants infected by hookworm has potential benefit, but further studies are needed to define the best clinical management of these cases.

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.

Histopathology of Gastric and Duodenal Strongyloides stercoralis Locations in Fifteen Immunocompromised Subjects

2006 ◽  
Vol 130 (12) ◽  
pp. 1792-1798 ◽  
Author(s):  
Francesco Rivasi ◽  
Silvio Pampiglione ◽  
Renzo Boldorini ◽  
Loredana Cardinale
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Duodenal Mucosa ◽  
Gastric Ulcers ◽  
Immunocompromised Patients ◽  
Histologic Diagnosis ◽  
Immunodeficiency Virus ◽  
Gastric Biopsies ◽  
Duodenal Biopsies

Abstract Context.—Strongyloidiasis is a worldwide parasitic infection affecting approximately 75 million people. In Italy, it was more prevalent in the past among rural populations of irrigated areas. Objective.—To determine the histopathologic alterations of the gastric and duodenal mucosa associated with the presence of Strongyloides stercoralis parasites. Design.—Fifteen cases of strongyloidiasis were observed in immunocompromised patients during a recent 6-year period in Italy. S stercoralis was found histologically in gastric biopsies (10 cases), in a gastrectomy (1 case), and in duodenal biopsies (9 cases). In 5 cases the parasite was present both in gastric and duodenal biopsies. Four patients were affected by lymphoma, 2 by multiple myeloma, 2 by gastric carcinoma, 1 by chronic myeloid leukemia, 1 by sideroblastic anemia, 1 by colorectal adenocarcinoma, 1 by chronic idiopathic myelofibrosis, 1 by chronic gastritis, 1 by gastric ulcers, and 1 by rheumatoid arthritis in corticosteroid therapy. No patient was affected by human immunodeficiency virus infection. Strongyloidiasis was not clinically diagnosed. Results.—Histologic examination revealed several sections of S stercoralis larvae, many eggs, and some adult forms. All the parasites were located in the gastric and/or the duodenal crypts. Eosinophils infiltrating into the lamina propria were found in all cases; their intensity was correlated with the intensity of the infection. Conclusions.—Histologic diagnosis of strongyloidiasis must be taken into consideration when examining both gastric and duodenal biopsies in immunocompromised patients, to avoid the development of an overwhelming infection of the parasite, which is dangerous for the life of the patient.

scholarly journals 346 Routine Emergency Department Laboratory Studies as Predictors of Emergency Department Stroke Severity

2018 ◽  
Vol 72 (4) ◽  
pp. S137
Author(s):  
A. Roka ◽  
A. Webb ◽  
J. Landeta ◽  
P. Banerjee ◽  
T. Macintosh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Stroke Severity ◽  
Laboratory Studies

scholarly journals Prevalence of intestinal parasitic infection in five farms in Holambra, São Paulo, Brazil

1995 ◽  
Vol 37 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Jun Kobayashi ◽  
Hideo Hasegawa ◽  
Archimedes A. Forli ◽  
Nancy F. Nishimura ◽  
Ademar Yamanaka ◽  
...  
Keyword(s):  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Sao Paulo ◽  
São Paulo ◽  
Infection Rates ◽  
Blastocystis Hominis ◽  
Culture Methods ◽  
E Coli ◽  
Parasitological Survey ◽  
Protozoan Species

A parasitological survey was carried out on 222 inhabitants of five farms in Holambra, located 30 km north of Campinas, São Paulo, Brazil, on October 1992. Approximately 70% of the inhabitants were found to be infected with at least one species of intestinal parasite. The positive rates of 6 helminths and 7 protozoan species detected are as follows: 5.4% Ascaris lumbricoides; 8.6% Trichuris trichiura; 19.8% Necator americanus; 10.4% Strongyloides stercoralis; 14% Enterobius vermicularis; 0.9% Hymenolepis nana; 3.2% Entamoeba histolytica; 2.7% E. hartmanni; 9.9% E. coli; 14.0% Endolimax nana; 2.3% Iodamoeba butschlii; 10.4% Giardia lamblia; 37.8% Blastocystis hominis. The positive rates of helminth infection were generaly higher in the younger-group under 16 years-old than those in the elder group aged 16 or more, whereas the infection rates of protozoan species were higher in the elder group. The infection rate of Strongyloides was found to be 10.4% by a newly developed sensitive method (an agarplate culture methods).

scholarly journals National State Survey to identify the presence of intestinal parasitic infections of mixed randomized patients as prevention who attended the IMSS laboratory

2020 ◽  
pp. 1-4
Author(s):  
Arcelia González-García ◽  
Claudia Hernández-Salas ◽  
Rosa Maria Martínez-Ortiz ◽  
Lilia González-Martínez
Keyword(s):  
Urban Areas ◽  
Intestinal Parasites ◽  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Parasitic Infections ◽  
Prevalence Rates ◽  
Cross Sectional ◽  
Intestinal Parasitic Infections ◽  
Control Programs ◽  
Intestinal Parasitosis

Introduction: Nowadays in our state, intestinal parasitic diseases are still endemic, with a greater frequency in rural and mountainous urban areas. After the years have elapsed since the last national survey, it was necessary to carry out a new survey to know the prevalence rates of intestinal parasitosis and to compare the results obtained between both studies. Such knowledge would be of great value in developing health strategies and designing intestinal parasitic infection control programs. Objective: to determine the current prevalence rates of intestinal parasites, to compare the results with those of the survey obtained. Methods: a random cross-sectional descriptive study was carried out during the months of December 2018 to March 2019 in a random sample of both sexes from the population of urban communities and the province of Zacatecas, Zac. Each one had a stool sample collected that was analyzed by the direct examination method, the Willis concentration technique, and the Kato-Katz examination; A questionnaire was also applied to them. Results: when comparing the results of the national and state surveys of intestinal parasitic infections carried out in 2009 and 2018, it was found that, in general, infections by parasites decreased, both helminths and pathogenic protozoa, although those infected with commensals increased their frequency in that of 2019. There was also a decrease in the frequency of infections by all species of soil-transmitted helminths, Trichuris trichiura, Ascaris lumbricoides, ancylostomideos, and Strongyloides stercoralis, as well as by the pathogenic protozoa Giardia lamblia and Entamoeba histolitica. Conclusions: when comparing the results of national and state surveys of intestinal parasite infections carried out in 2018 and 2019, it was found that in general the frequencies of infections with intestinal parasites decreased. The finding in both studies of a higher frequency of infection with parasites or commensals in the group aged 5 to 14 years (school age), supports the recommendation to place emphasis on control programs for intestinal parasites in this age group.

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