Strongyloides hyperinfection syndrome complicating (ectopic) Cushing syndrome.
Strongyloidiasis can present with a wide variety of symptoms and can lead to a potentially fatal hyperinfection. Although any factors that suppress the host defense mechanisms can potentially trigger hyperinfection, prolonged steroid use has been quite well described. A patient with disseminated small cell lung cancer suffered a Strongyloides stercoralis hyperinfection syndrome complicating ectopic adrenocorticotropic hormone (Cushing syndrome). Evaluation revealed lymphopenia, elevated levels of adrenocorticotropic hormone in the setting of elevated cortisol levels, a normal pituitary, and metastatic malignancy. S. stercoralis larval forms were seen in the stool and sputum. At autopsy, S. stercoralis larval forms were seen in the lung along with evidence of metastatic small cell lung carcinoma.
Vadlamudi
Raja S
RS
Section of General Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. rvadlamu@wfubmc.edu
Van Dort
Martin
M
Barklow
Thomas
T
Byrd
Ryland P
RP
Moorman
Jonathan P
JP
D000368:Aged; D003480:Cushing Syndrome / Q000150:complications*; D017809:Fatal Outcome; D006801:Humans; D008174:Lung Diseases, Parasitic / Q000150:complications* / Q000503:physiopathology; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D055752:Small Cell Lung Carcinoma / Q000150:complications*; D013322:Strongyloidiasis / Q000150:complications* / Q000503:physiopathology