[Strongyloides stercoralis infection in a patient with AIDS and non-Hodgkin lymphoma].
METHODS
The patient, now 50 years old, an immigrant miner from the former Yugoslavia who was known to have AIDS, was in 1992 found to have non-Hodgkin lymphoma of the oesophagus and given five cycles of multiple chemotherapy (CHOP) with complete remission. Subsequently he complained of retrosternal pain, dysphagia, dry cough and upper abdominal discomfort. On admission he had slight fever of 39.1 degrees C, but physical examination was unremarkable.


METHODS
Blood count revealed an eosinophilia of 41%. IgE concentration was raised to 432IU/ml. The CD4+ T-cell count was reduced to 10/microliter, that of CD8+ to 89/microliter.
Blood culture, fecal and sputum samples and bronchoalveolar lavage demonstrated Mycobacterium avium intracellulare.


METHODS
Treatment of the disseminated atypical mycobacterial infection was started with clarithromycin, rifabutin, ciprofloxacin and ethambutol. There was no improvement of the upper abdominal discomfort, but the fever subsided. Oesophagogastroscopy excluded recurrence of the lymphoma. Biopsy and examination of the duodenal juice revealed worms and larvae of Strongyloides stercoralis. Stool samples contained no mycobacteria, but strongyloides larvae were demonstrated. Albendazole was given (2 x 400 mg daily for 6 days, followed by a maintenance dose of 1 x 400 mg daily). Repeat endoscopy and stool sample after a month no longer showed any parasites.


CONCLUSIONS
Even in Western Europe, persons coming from endemic areas who, as this patient, have various risk factors that may facilitate the occurrence of strongyloidiasis. With early diagnosis and treatment albendazole is an efficacious drug.
Müller
A
A
Klinik I für Innere Medizin, Universität zu Köln.
Fätkenheuer
G
G
Salzberger
B
B
Schrappe
M
M
Diehl
V
V
Franzen
C
C
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000208:ethnology; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D004386:Duodenum / Q000469:parasitology; D005243:Feces / Q000469:parasitology; D005858:Germany; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000188:drug therapy; D009364:Neoplasm Recurrence, Local; D013270:Stomach / Q000469:parasitology; D017171:Strongyloides stercoralis / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000150:complications* / Q000188:drug therapy / Q000208:ethnology; D015022:Yugoslavia / Q000208:ethnology
D000871:Anthelmintics; D015766:Albendazole