Acute respiratory distress syndrome due to Strongyloides stercoralis infection in a patient with cervical cancer.
A 62-year-old woman complained of diarrhea and vomiting after receiving chemotherapy for cervical cancer in association with high doses of corticosteroids. Two months later, the patient developed acute respiratory distress syndrome, and numerous Strongyloides stercoralis parasites were found in the intrabronchial discharge. Ivermectin was administered daily until nematodes were no longer detected in the sputum, and the patient's condition was successfully rescued. Antibodies for human T-cell lymphotropic virus-1 (HTLV-1) were positive. HTLV-1 infection and the administration of corticosteroids are known risk factors for strongyloides hyperinfection syndrome. Therefore, physicians should consider this disease in the differential diagnosis of patients from endemic areas who present with gastrointestinal symptoms under these risk factors.
Department of Infectious Diseases, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Japan.
Takeshi
T
Kinjo
Daijiro
D
Nabeya
Hideta
H
Nakamura
Shusaku
S
Haranaga
Tetsuo
T
Hirata
Tomoko
T
Nakamoto
Eriko
E
Atsumi
Tatsuya
T
Fuchigami
Yoichi
Y
Aoki
Jiro
J
Fujita
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000818:Animals; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D012307:Risk Factors; D013183:Sputum / Q000469:parasitology*; D017171:Strongyloides stercoralis / Q000187:drug effects; D013322:Strongyloidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D007559:Ivermectin