Hyperinfection syndrome in strongyloidiasis: Report of two cases

Luciano B. Lemos, Zhenhong Qu, Rodolfo Laucirica, Herbert L. Fred

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Hyperinfection in strongyloidiasis has been associated with corticosteroid treatment. Other immunodepressive conditions also seem to facilitate the state of hyperinfection. The etiologic diagnosis of this parasitosis can be difficult to reach and a positive urine microscopy is unusual. We report two patients under corticosteroid therapy with disseminated strongyloidiasis; both had eosinophilia. The first patient, followed for 8 years for autoimmune hemolytic anemia, recently developed abdominal symptoms. A colonoscopy was performed 1 month before admission and the biopsy was thought to show nonspecific changes. At admission, few larvae of Strongyloides stercoralis were disclosed by urine microscopy, and a review of the colonic biopsy uncovered a few larvae of Strongyloides. The patient received antihelmintic therapy with a dramatic improvement. The second patient, under treatment for lupus erythematosus for 3 years, was admitted with pulmonary symptoms and during admission developed massive gastrointestinal bleeding. Disseminated strongyloidiasis was discovered only at autopsy. The low suspicion index for strongyloidiasis resulted in delaying the etiologic diagnosis in one patient and in failing to diagnose the disease in the other. The morphologic features of the parasite in the two cases are presented with emphasis on the difficulties of recognizing the larvae in the intestinal biopsy.

Original languageEnglish (US)
Pages (from-to)87-94
Number of pages8
JournalAnnals of Diagnostic Pathology
Volume7
Issue number2
DOIs
StatePublished - Jan 1 2003

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Strongyloidiasis
Larva
Biopsy
Microscopy
Adrenal Cortex Hormones
Urine
Strongyloides
Strongyloides stercoralis
Autoimmune Hemolytic Anemia
Anthelmintics
Eosinophilia
Colonoscopy
Therapeutics
Autopsy
Parasites
Hemorrhage
Lung

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Hyperinfection syndrome in strongyloidiasis : Report of two cases. / Lemos, Luciano B.; Qu, Zhenhong; Laucirica, Rodolfo; Fred, Herbert L.

In: Annals of Diagnostic Pathology, Vol. 7, No. 2, 01.01.2003, p. 87-94.

Research output: Contribution to journalArticle

Lemos, Luciano B. ; Qu, Zhenhong ; Laucirica, Rodolfo ; Fred, Herbert L. / Hyperinfection syndrome in strongyloidiasis : Report of two cases. In: Annals of Diagnostic Pathology. 2003 ; Vol. 7, No. 2. pp. 87-94.
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