title: Strongyloidiasis: an unusual cause of septic shock with pneumonia and enteropathy in western countries.
abstract: We report a case of invasive strongyloidiasis in a patient from the French Antilles who had been living in France for many years, with no history of immunosuppression, and who was hospitalised in the intensive care unit for septic shock with multimicrobial hypoxaemia pneumonia and exudative enteropathy. Initiation of systemic corticosteroid therapy for septic shock seems to have precipitated onset of the parasitic infection, with recurrence of hypoxaemic pneumonia complicated by hypoxic cardiac arrest. The diagnosis was confirmed after roundworm larvae were found on bronchoalveolar lavage. Treatment with ivermectin was initiated, but the patient died in a context of postanoxic encephalopathy.
authors.affiliation: Intensive Care Unit, University Hospital of Besançon, Besançon, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Montini
authors.affiliation: Parasitology Unit, University Hospital of Besançon, Besançon, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Grenouillet
authors.affiliation: Intensive Care Unit, University Hospital of Besançon, Besançon, France EA3920 and SFR FED 4234.
authors.forename: Gilles
authors.initials: G
authors.lastname: Capellier
authors.affiliation: Intensive Care Unit, University Hospital of Besançon, Besançon, France EA3920 and SFR FED 4234.
authors.forename: Gaël
authors.initials: G
authors.lastname: Piton
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D017809:Fatal Outcome; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000209:etiology*; D012008:Recurrence; D012772:Shock, Septic / Q000188:drug therapy / Q000469:parasitology*; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis
chemical_list: D000305:Adrenal Cortex Hormones
references.citation: CMAJ. 2004 Aug 31;171(5):479-84
references.pmid: 15337730
references.citation: Intensive Care Med. 2013 Feb;39(2):339-40
references.pmid: 23108609
references.citation: JAMA. 2011 Dec 21;306(23):2594-605
references.pmid: 22187279
references.citation: Cytopathology. 2010 Oct;21(5):345-7
references.pmid: 20545724
references.citation: Int J Antimicrob Agents. 2013 Dec;42(6):580-3
references.pmid: 24269075
references.citation: Acta Gastroenterol Belg. 2008 Oct-Dec;71(4):413-7
references.pmid: 19317285
references.citation: Infection. 2011 Apr;39(2):161-5
references.pmid: 21246247
references.citation: Curr Opin Infect Dis. 2010 Oct;23(5):500-4
references.pmid: 20733481
references.citation: J Am Acad Dermatol. 2010 Nov;63(5):896-902
references.pmid: 20172622
references.citation: Am J Trop Med Hyg. 2012 Aug;87(2):195
references.pmid: 22855744
references.citation: Ann Pharmacother. 2007 Dec;41(12):1992-2001
references.pmid: 17940124