Clinical and imaging features of pulmonary strongyloidiasis.
We evaluated 20 patients with pulmonary strongyloidiasis for risk factors, clinical and imaging manifestations, complications, treatment, and outcome. Eighteen (90%) had risk factors for strongyloidiasis including steroid use, age greater than 65, chronic lung disease, use of histamine blockers, or chronic debilitating illness. Pulmonary signs and symptoms, including cough, shortness of breath, wheezing, and hemoptysis, were present in 19 (95%); adult respiratory distress syndrome (ARDS) developed in 9 (45%). Pulmonary infiltrates occurred in 18 (90%). Gastrointestinal signs and symptoms were also common. Peripheral blood eosinophilia occurred in 15 (75%). Twelve (60%) had secondary infection, and 3 (15%) had bacterial lung abscesses. All were treated with thiabendazole, 25 mg/kg twice daily; on average, patients without ARDS were treated for 3 days, versus 7 days for those with ARDS. Seventy percent responded to therapy; 30% died. Preexisting chronic lung disease and ARDS were statistically significant predictors of a poor prognosis.
Department of Diagnostic Radiology, University of Kentucky Medical Center, Lexington 40536-0084, USA.
J H
JH
Woodring
H
H
Halfhill
R
R
Berger
J C
JC
Reed
N
N
Moser
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000969:Antinematodal Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000209:etiology; D008174:Lung Diseases, Parasitic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000209:etiology; D013902:Radiography, Thoracic; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013827:Thiabendazole / Q000008:administration & dosage
D000969:Antinematodal Agents; D013827:Thiabendazole