Journal List > Tuberc Respir Dis > v.68(1) > 1001499

Kim, Kim, Yun, Ju, Ma, Lee, Cho, Kim, Lee, Hwang, and Jeong: A Case of Fatal Hyperinfective Strongyloidiasis with Acute Respiratory Failure and Intestinal Perforation in Lung Cancer Patient

Abstract

Strongyloides stercoralis is an intestinal nematode that is a parasite to humans. The infecting filariform larvae of S. stercoralis enters the host body via the bloodstream, passes through the lungs, penetrates the alveoli, and then ascends the airway to transit down the esophagus into the small bowel. The infection can persist for decades without causing major symptoms and can elicit eosinophilia of varying magnitudes. Of note, this infection can also develop into a disseminated, often fatal, disease (hyperinfection) in patients receiving immunosuppressive corticosteroids. A 65-year-old man who was receiving corticosteroid therapy for the treatment of spinal stenosis was admitted to the emergency room with complaints of abdominal pain and severe dyspnea. We detected many S. stercoralis larvae in the sputum and in the bronchoalveolar-lavage sample collected by bronchoscopy. Here, we report a fatal case of strongyloidiasis with acute respiratory failure and intestinal perforation. In addition, we provide a brief review of the relevant medical literature.

Figures and Tables

Figure 1
Chest PA shows numerous ill-defined tiny nodules and diffuse, bilateral ground-glass opacities in both lung fields.
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Figure 2
Chest HRCT (A), Chest CT (B) reveals diffuse, bilateral ground-glass opacities in both lung fields and 3.2 cm sized, spiculated mass in the right upper lung zones.
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Figure 3
The third stage filariform larvae of Strongyloides stercoralis in sputums has typically a notched tail (arrow) (Papanicolaou, ×100).
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Figure 4
The third stage filariform larvae of Strongyloides stercoralis obtained through bronchoalveolar lavage (Papanicolaou, ×100).
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