Disseminated Strongyloides stercoralis infection.
A case of disseminated S stercoralis is an immunosuppressed patient manifested with diarrhea, a rash, and progressive respiratory insufficiency. The parasites were eradicated with thiabendazole despite continued steroid therapy, and the patient survived the hospitalization. The characteristics of S stercoralis allow it to be harbored within a host for prolonged periods of time, only to disseminate once cell-mediated immunity is suppressed. A diagnosis of strongyloidiasis should be considered in an immunocompromised patient with a petechial rash. Prompt diagnosis and initiation of thiabendazole therapy provides the greatest opportunity for patient survival. Secondary bacterial infections should be aggressively sought. Mortality from disseminated strongyloidiasis approaches 80%.
Simpson
W G
WG
Department of Medicine, University of Kentucky, Lexington 40536-0084.
Gerhardstein
D C
DC
Thompson
J R
JR
D000368:Aged; D000818:Animals; D001932:Brain Neoplasms / Q000601:surgery; D006332:Cardiomegaly / Q000469:parasitology; D003399:Craniotomy; D005260:Female; D005767:Gastrointestinal Diseases / Q000469:parasitology*; D005909:Glioblastoma / Q000601:surgery; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007629:Kentucky; D011183:Postoperative Complications; D011693:Purpura / Q000469:parasitology; D012141:Respiratory Tract Infections / Q000469:parasitology; D012874:Skin Diseases, Infectious / Q000469:parasitology; D013183:Sputum / Q000469:parasitology; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D013827:Thiabendazole / Q000627:therapeutic use
D013827:Thiabendazole