Document Detail


Clinical manifestations of strongyloidiasis in southern Taiwan.
MedLine Citation:
PMID:  11950117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The diagnosis and management of strongyloidiasis present a continuous challenge in developing countries including Taiwan. In this study, the clinical characteristics and microbiological findings of 27 patients with Strongyloides stercoralis infection were retrospectively analyzed. Intestinal infection was identified in 17 patients and hyperinfection syndrome or disseminated disease in 10 (including 2 autopsy cases). The most frequent clinical findings were diarrhea (74%), fever (70%), abdominal pain (59%), cough (37%), dyspnea (33%), and constipation (26%). The common initial laboratory abnormalities were leukocytosis (81%), anemia (67%), liver function impairment (52%), and eosinophilia (44%). Most of the 27 patients had comorbid conditions, including malnutrition in 20 (74%), corticosteroid dependence in 15 (55%), chronic obstructive pulmonary disease in 9 (33%), chronic liver disease or cirrhosis in 8 (30%), and peptic ulcer disease in 7 (26%). There was no difference in the time interval from symptom onset to diagnosis between the intestinal infection group and the hyperinfection/disseminated group (22 +/- 15 vs 17 +/- 9 days). Larvae of S. stercoralis were identified in the stool of 24 patients, in the sputum smear of 5, in the gastric biopsy of one, and on histology of autopsy specimens in 2. Twenty-six patients received antiparasitic drug therapy of variable duration (mebendazole in 24, albendazole in 2, combined therapy in one). The overall cure rate was 52% (14/27). Relapse occurred in 4 patients. The overall mortality was 26% (7/27). There was a high mortality (up to 50%) in the hyperinfection/disseminated disease group. In conclusion, diagnosis of strongyloidiasis is often delayed and overlooked because of nonspecific symptoms. Physicians in endemic regions should include strongyloidiasis in the differential diagnosis when patients present with gastrointestinal and/or pulmonary symptoms with peripheral eosinophilia.
Authors:
Hung-Chin Tsai; Susan S Lee; Yung-Ching Liu; Wei-Ru Lin; Chun-Kai Huang; Yao-Shen Chen; Shue-Ren Wann; Tsung-Hung Tsai; Hsi-Hsun Lin; Muh-Yong Yen; Chuan-Min Yen; Eng-Rin Chen
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi     Volume:  35     ISSN:  1684-1182     ISO Abbreviation:  J Microbiol Immunol Infect     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-04-12     Completed Date:  2002-10-03     Revised Date:  2007-06-21    
Medline Journal Info:
Nlm Unique ID:  100956211     Medline TA:  J Microbiol Immunol Infect     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  29-36     Citation Subset:  IM    
Affiliation:
Department of Medicine, Kaohsiung Veterans General Hospital, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Animals
Child
Child, Preschool
Female
Humans
Male
Middle Aged
Strongyloides stercoralis / isolation & purification*
Strongyloidiasis / complications*,  drug therapy,  etiology

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