A 73-year-old Korean male was admitted to Jeil hospital with clinical complaints of backache, cough, sputum, vomiting and diarrhea. He had a history of long term administration of prednisolone. At admission he was comatose and showed generalized pitting edema and anasarca. Laboratory data revealed leukocytosis, hyperproteinemia with hypoalbuminemia, sepsis, anemia and brown-colored urine. Stool examination revealed rhabditiform nematode larvae. By fecal cultivation, filariform larvae of Strogyloides were obtained and the patient was diagnosed as hyperinfection syndrome due to S. stercoralis infection. On the 3rd day of hospitalization, albendazole treatment was started and continued for 4 days. On the 7th dsy of hospitalization, sputum revealed filariform larvae. Total 619 parasitic adult females, expelled by chemotherapy, were collected from the diarrheal stool. However, the patient was discharged hopelessly and died at home.
parasitology-helminth-nematoda ; strongyloidiasis ; Strongyloides stercoralis ; case report

This is a case of a 52 year-old female admitted in the medicine ward of the Philippine General Hospital (PGH) for drowsiness, fever and jaundice. This paper will illustrate an unusual case of encephalopathy, chronic abdominal pain and jaundice due to disseminated strongyloidiasis. Four months prior to admission (PTA), the patient sought consult for on and off right lower quadrant abdominal pain, easy fatigability, generalized body weakness, and vomiting of previously ingested food. Physical examination revealed pallor, right costovertebral angle and right lower quadrant abdominal tenderness. Work-up done showed a urinary tract infection and hookworm. An ultrasound of the kidneys and urinary bladder did not reveal any renal abscess and showed only a hyperechoic mass confirmed to be angiomyolipoma by abdominal CT scan. Bilateral renal cysts were also noted. Treatment for the urinary tract infection and hookworm were prescribed. She was lost to follow up.
Human ; Female ; Middle Aged ; PARASITIC DISEASES ; STRONGYLOIDIASIS ; SIGNS AND SYMPTOMS ; ULTRASONOGRAPHY

Strongyloides stercoralis hyperinfection syndrome is a rare complication of strongyloidiasis that frequently occurs in immunosuppressed patients. The parasite ordinarily localizes in the small intestines, especially in the duodenal and jejunal part. Reports of gastric involvement are rare. We report a case of an immunosuppressed patient who had severe S. stercoralis infection of the stomach in association with purulent meningitis.
Gastritis ; Humans ; Intestine, Small ; Meningitis* ; Parasites ; Stomach* ; Strongyloides stercoralis* ; Strongyloides* ; Strongyloidiasis

Strongyloides stercoralis, which has two different generations: the free living and parasitic generation, is primarily adapted to warm climates, but strongyloidiasis has been reported sporadically in temperate and cold regions. Strongyloidiasis may be asymptomatic in almost 50 percent of the cases, rarely, infestation presents with severe clinical pictures. The reason for this exacerbation of illness is probably a rapid increase in the number of infecting larvas through the development or acceleration of a cycle of autoinfection. A breakdown of the host-parasite equilibrium due to decreased host resistance may occur in malnutrition, debilitating diseases or therapy with immunosuppressive drugs. Corticosteroid treatment may have an important role in the sudden occurrence of severe stongyloidiasis. We experienced a case of strongyloidiasis with severe malnutrition, accompanied with bronchial asthma and diabetes mellitus. This patient has been treated with corticosteroid for several years. So, we report this rare case with the literature review.
Acceleration ; Asthma ; Climate ; Diabetes Mellitus ; Family Characteristics ; Humans ; Larva ; Malnutrition* ; Strongyloides stercoralis ; Strongyloidiasis*

Surveys on helminthic fauna of the nutria, Myocastor coypus, have seldom been performed in the Republic of Korea. In the present study, we describe Strongyloides myopotami (Secernentea: Strongyloididae) recovered from the small intestine of feral nutrias. Total 10 adult nutrias were captured in a wetland area in Gimhae-si (City), Gyeongsangnam-do (Province) in April 2013. They were transported to our laboratory, euthanized with ether, and necropsied. About 1,300 nematode specimens were recovered from 10 nutrias, and some of them were morphologically observed by light and scanning electron microscopies. They were 3.7-4.7 (4.0+/-0.36) mm in length, 0.03-0.04 (0.033) mm in width. The worm dimension and other morphological characters, including prominent lips of the vulva, blunted conical tail, straight type of the ovary, and 8-chambered stoma, were all consistent with S. myopotami. This nematode fauna is reported for the first time in Korea.
Animals ; Republic of Korea/epidemiology ; Rodent Diseases/epidemiology/*parasitology ; Rodentia ; Strongyloides/*isolation & purification ; Strongyloidiasis/epidemiology/parasitology/*veterinary

OBJECTIVETo communicate the presence of adult females, rabditoid larvae and eggs of Strongyloides stercoralis (S. stercoralis) in the respiratory secretions obtained by tracheal aspirate from a HIV-negative patient who was suffering from polymyositis, and treated with corticoids and amethopterin and assisted by pneumonia.

METHODSThe respiratory secretions submitted to the Parasitology Laboratory of the Muñiz Hospital were made more concentrated by centrifugation (1 500 r/min for 15 seconds). Wet mount microscopy was performed with the pellet.

RESULTSIt revealed adult females, rabditoid larvae and eggs of S. stercoralis. Further parasitological studies performed after the start of the treatment with ivermectin on fresh fecal samples, gastric lavages and tracheal aspirates showed scanty mobile filariform and rabditoid larvae of the same parasite.

CONCLUSIONSThe presence of adult female S. stercoralis which has never been observed before in the clinical samples submitted to our Laboratory for investigation can be considered as an indirect marker of the severe immunosupression of the patient.

Animals ; Female ; Humans ; Life Cycle Stages ; Middle Aged ; Strongyloides stercoralis ; cytology ; growth & development ; Strongyloidiasis ; diagnosis ; parasitology

Strongyloides stercoralis is an intestinal nematode with a complex life cycle, including a free living cycle, a parasitic cycle, and an auto-infection cycle. S. stercolaris infection may occur in both immunocompetent and immunocompromised individuals. It is usually asymptomatic and undetectable for decades in a healthy host. In immunocompromised patient, however, it may cause life threatening hyperinfection involving multiple organs. In Korea, several cases of Strongyloides hyperinfection have been reported since 1959. However, reports with gastric involvement and peritoneal invasion are rare. This is a report of gastric strongyloidiasis hyperinfection identified at ascites in an elderly patient who had subtotal gastrectomy due to stomach cancer.
Aged* ; Ascites ; Gastrectomy ; Humans ; Immunocompromised Host ; Ivermectin ; Korea ; Life Cycle Stages ; Parasitology ; Stomach Neoplasms* ; Strongyloides stercoralis ; Strongyloides* ; Strongyloidiasis

Strongyloides stercoralis is a nematode that may involve any segment of the Gl tract or virtually every human organ because of its autoinfection cycle and hyperinfection. It may occur in either immunocompetent or immunocompromised individuals. A 72-year-old woman who had no notable medical history presented with chronic diarrhea and generalized edema and she revealed protein losing eneteropathy. She was diagnosed with Strongyloidiasis infection through EGD and a colonoscopic biopsy specimen at a time when there were rhabditiform larvae present. The patient was treated with albendazole 400 mg/day for three days. At the follow-up three months later, the endoscopic biopsy specimens revealed no evidence of Strongyloidiasis infection and her clinical symptoms had progressively improved. The present case represents a rare report of Strongyloidiasis in a immunocompetent patient diagnosed through EGD and the colonoscopic biopsy specimen concurrently. So, we report on this case along with a review of the relevant literature.
Aged ; Albendazole ; Biopsy ; Colon ; Diarrhea ; Edema ; Female ; Follow-Up Studies ; Humans ; Hypoalbuminemia ; Larva ; Stomach ; Strongyloides ; Strongyloides stercoralis ; Strongyloidiasis

Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy.
Acute Disease ; Adrenal Cortex Hormones ; Diagnosis ; Humans ; Immunocompromised Host ; Pulmonary Disease, Chronic Obstructive* ; Strongyloides ; Strongyloides stercoralis ; Strongyloidiasis*

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Aged ; Animals ; Fatal Outcome ; Humans ; Immunocompromised Host ; Larva ; Male ; Sputum ; Strongyloides/growth & development/*isolation & purification ; Strongyloidiasis/*etiology ; Superinfection/*parasitology