Lab Med Online.  2019 Jul;9(3):171-176. 10.3343/lmo.2019.9.3.171.

A Case of Chronic Strongyloidiasis with Recurrent Hyperinfection

Affiliations
  • 1Department of Laboratory Medicine, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea. mnkim@amc.seoul.kr
  • 2Department of Internal Medicine, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea.
  • 3Department of Oncology, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea.
  • 4Department of Infectious Diseases, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea.

Abstract

Strongyloides stercoralis is an intestinal nematode that often causes chronic diarrhea and may develop severe complicated form of hyperinfection or disseminated infection in immunocompromised patients. Here, we report a case of recurrent strongyloidiasis presenting with pulmonary and meningeal involvement. A 55-year-old male diagnosed with pancreatic cancer 4 months ago was admitted due to chronic diarrhea, abdominal pain, and weight loss for 2-3 months. He had been treated with albendazole for chronic recurrent strongyloidiasis 13 years ago and again 2 years ago. He developed sepsis of Klebsiella pneumoniae and Escherichia coli on Days 3 and 7, respectively, and then meningitis of E. coli on Day 42. Strongyloidiasis was diagnosed by detection of abundant filariform larvae in sputum specimens on Day 15. He was treated for disseminated strongyloidiasis with albendazole and ivermectin for five weeks until clearance of larvae was confirmed in sputum and stool specimens. Laboratory diagnosis is important to guide appropriate treatment and to prevent chronic and recurrent strongyloidiasis.

Keyword

Strongyloides stercoralis; Chronic; Recurrent; Hyperinfection; Sepsis; Meningitis

MeSH Terms

Abdominal Pain
Albendazole
Clinical Laboratory Techniques
Diarrhea
Escherichia coli
Humans
Immunocompromised Host
Ivermectin
Klebsiella pneumoniae
Larva
Male
Meningitis
Middle Aged
Pancreatic Neoplasms
Sepsis
Sputum
Strongyloides stercoralis
Strongyloidiasis*
Weight Loss
Albendazole
Ivermectin
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