Document Detail


Strongyloidiasis in patients at a comprehensive cancer center in the United States.
MedLine Citation:
PMID:  15042689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The frequency of Strongyloides stercoralis infestation and complication in patients with cancer in the United States is unknown. METHODS: The authors performed a retrospective analysis of S. stercoralis infection in patients who were undergoing cancer treatment at The University of Texas M. D. Anderson Cancer Center (Houston, TX). RESULTS: The overall S. stercoralis infection frequency was approximately 1.0 per 10,000 new cancer cases between 1971 and 2003. Twenty-two of 25 patients (88%) were U.S. residents (19 from Texas; 1 each from Mississippi, Tennessee, and Puerto Rico), and the remaining 3 (13%) were from Latin America. Thirteen (52%) had solid-organ malignancies, whereas 12 (48%) had hematologic malignancies (lymphoma or multiple myeloma, n=8; leukemia, n=3; aplastic anemia, n=1). Twelve patients (48%) received systemic corticosteroids, 9 (36%) received antineoplastic therapy, and 2 underwent hematopoietic stem cell transplantation (HSCT). Diarrhea was reported in 13 patients (57%), and eosinophilia was observed in 11 patients (48%); 4 patients (16%) had probable hyperinfection syndrome (in 3 cases of polymicrobial gram-negative bacteremia, 1 patient had Klebsiella pneumoniae pneumonia, whereas 1 patient presented with K. pneumoniae lung infection alone). Evidence of definite pulmonary hyperinfection syndrome was observed in 2 HSCT recipients (8%). Fourteen (74%) of 19 patients responded to thiabendazole therapy. Two patients with definite pulmonary hyperinfection syndrome developed fatal S. stercoralis hemorrhagic alveolitis despite receiving high-dose thiabendazole plus ivermectin therapy. CONCLUSIONS: In the current study, strongyloidiasis was uncommon in patients with cancer and remained localized in individuals with solid-organ malignancies. Definite pulmonary accelerated autoinfections were observed only in HSCT recipients. Therefore, pre-HSCT S. stercoralis screening in individuals from endemic regions of the United States warrants further study.
Authors:
Amar Safdar; Kumthorn Malathum; Saul J Rodriguez; Rola Husni; Kenneth V I Rolston
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer     Volume:  100     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-25     Completed Date:  2004-05-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1531-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2004 American Cancer Society.
Affiliation:
Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA. asafdar@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antinematodal Agents / therapeutic use
Bronchoalveolar Lavage
Child
Feces / parasitology
Female
Humans
Male
Middle Aged
Neoplasms / complications*,  parasitology
Retrospective Studies
Strongyloidiasis / complications,  drug therapy,  epidemiology*
Thiabendazole / therapeutic use
Treatment Outcome
United States
Chemical
Reg. No./Substance:
0/Antinematodal Agents; 148-79-8/Thiabendazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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