Objective:To 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 w...Objective:To 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.Methods:The respiratory secretions submitted to the Parasitology Laboratory of the Mu(?)iz Hospital were made more concentrated by centrifugation(1 500 r/min for 15 seconds).Wet mount microscopy was performed with the pellet.Results:It 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.Conclusions:The 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.展开更多
AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis(S.stercoralis)hyperinfection. METHODS:Over a period of 23 years(1984-2006),we investigated 25 pat...AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis(S.stercoralis)hyperinfection. METHODS:Over a period of 23 years(1984-2006),we investigated 25 patients withS.stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis.The clinical and endoscopic findings were analyzed retrospectively. RESULTS:Twenty-four(96%)of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1(HTLV-1)infection.The abnormal endoscopic findings,mainly edematous mucosa,white villi and erythematous mucosa,were observed in 23(92%) patients.The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy.The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative(Endoscopic severity score:4.86±2.47vs 2.71 ±1.38,P<0.05). CONCLUSION:Our study clearly demonstrates that,in addition to stool analysis,endoscopic observation and biopsies are very important.We also emphasize that S.stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.展开更多
BACKGROUND Strongyloidiasis is usually a chronic infection but it can develop into a fatal disease in immunosuppressed patients.CASE SUMMARY A 68-year-old male with rheumatoid arthritis was treated with a variety of i...BACKGROUND Strongyloidiasis is usually a chronic infection but it can develop into a fatal disease in immunosuppressed patients.CASE SUMMARY A 68-year-old male with rheumatoid arthritis was treated with a variety of immunosuppressants for the past 3 years.Recently,the patient presented with a partial small-bowel obstruction,petechia,coughing and peripheral neuropathy.The diagnosis was difficult to clarify in other hospitals.Our hospital found Strongyloides stercoralis larvae with active movement in the routine stool and sputum smears.The diagnosis of disseminated strongyloidiasis was established.Ivermectin combined with albendazole was used for treatment.The patient responded to therapy and was discharged.CONCLUSION This case underscores the importance of comprehensive differential diagnosis in immunocompromised patients.展开更多
Strongyloidiasis is endemic to the entire inter-tropical zone.Newly infected people are the most prone to experience the symptoms of this intestinal nematodosis.In this article,a 38-year old German citizen consulted f...Strongyloidiasis is endemic to the entire inter-tropical zone.Newly infected people are the most prone to experience the symptoms of this intestinal nematodosis.In this article,a 38-year old German citizen consulted for bowel movement disturbances and dyspepsia as well as diffuse and erratic pruritus,and was finally diagnosed with to have strongylodiasis is presented and discussed.展开更多
Infections caused by Strongyloides stercoralis(S.stercoralis) in human are generally asymptomatic,however in immunocompromised individual,hyperinfection may develop with dissemination of larvae to extra-intestinal org...Infections caused by Strongyloides stercoralis(S.stercoralis) in human are generally asymptomatic,however in immunocompromised individual,hyperinfection may develop with dissemination of larvae to extra-intestinal organs.The diagnosis could be easily missed due to asymptomatic presentation and insufficient exposure towards the infection itself,which may lead to low index of suspicion as a consequence.In this report,a case of a Malaysian male with underlying diabetes mellitus,hypertension,cerebrovascular accident,bullous pemphigus and syndrome of inappropriate antidiuretic hormone secretion who initially complained of generalized body weakness and poor appetite without any history suggestive of sepsis is presented.However,he developed septicemic shock later,and S.stercoralis larvae was incidentally found in the tracheal aspirate that was sent to look for acid fast bacilli.Regardless of aggressive resuscitation,the patient succumbed due to pulmonary hemorrhage and acute respiratory distress syndrome.It was revealed that the current case has alarmed us via incidental finding of S.stercoralis larvae in the tracheal aspirate,indicating that the importance of the disease should be emphasized in certain parts of the world and population respectively.展开更多
Objective:To determine the prevalence of intestinal parasitic infections among mentally retarded residents of rehabilitation center of Bandar Abbas,Hormozgan province,southern Iran.Methods:A cross-sectional study was ...Objective:To determine the prevalence of intestinal parasitic infections among mentally retarded residents of rehabilitation center of Bandar Abbas,Hormozgan province,southern Iran.Methods:A cross-sectional study was carried out in central rehabilitation institute of Hormozgan province in summer 2010.Fecal samples of all 133 residents(72 males,61 females)aged 3-52,were collected in triplicate.Specimens were examined by direct smear,formalin-ether concentration techniques and stained by permanent Trichrome,Ziehl-Neelsen stains.Statistical analysis was conducted by SPSS 13.5.Results:Intestinal parasitic infections were seen in 48.5%(64 out of 133 subjects:53.4%in males and 46.6%in females).Strongyloides stercoralis with17.3%showed the highest incidence followed by Entamoeba coli(9.8%),Blastocystis hominis(7.5%),Giardia lamblia(2.3%),Endolimax nana(2.3%),Hymenolepis nana(0.8%),Oxyuris vermicularis(0.8%),and Chilomasix mesnili(0.8%).Double infections were found to be as:Strongyloides stercoralis+Giardia lamblia(2.3%),Entamoeba coli+Giardia lamblia(1.5%),Entamoeba coli+Blastocystis hominis(1.5%),Oxyuris vermicularis+Entamoeba coli(0.8%),Strongyloides stercoralis+Entamoeba coli(0.8%),respectively.Conclusions:Our findings reveal that strongyloidiasis is a common disease among mentally retarded population in southern Iran.展开更多
Background:Strongyloidiasis,a neglected disease caused by intestinal nematodes of the genus,is endemic to tropical and subtropical areas such as Vietnam.Morphological methods only identify the genus,while DNA-molecula...Background:Strongyloidiasis,a neglected disease caused by intestinal nematodes of the genus,is endemic to tropical and subtropical areas such as Vietnam.Morphological methods only identify the genus,while DNA-molecular techniques are susceptible in Strongyloides spp.detection.The study aims to determine the prevalence of dominant Strongyloides species among the population in Duc Hoa district,Long An,Vietnam.Methods:A cross-sectional study used 1190 stool specimens collected from July 2017 to November 2018.All samples were transported within 2 h,stored at 2-8℃,and processed within 48 h for microscopy smear and culture at the Laboratory of Medical Parasitology,Pham Ngoc Thach University of Medicine(PNT).Then all positive samples with the above 2 methods were verified by real-time PCR technique.Real-time PCR amplification was conducted at the Laboratory of Molecular Biology,PNT.Results:Direct microscopy and modified Harada-Mori culture detected Strongyloides spp.larvae in 79/1190 sam-ples(6.6%).About 94.2%of the DNA samples were Strongyloides stercoralis,2.9%were co-infections with Strongy-loides ratti and S.stercoralis,and 2.9%were patients with S.ratti.The identity of 12/14 sequences was confirmed as S.stercoralis with a high level of similarity(91.3%-100%)and over 98%for S.ratti.Conclusion:DNA-molecular techniques and sequence analysis are highly suitable for identifying Strongyloides species isolated from stool samples.It is remarkable evidence of the presence of zoonosis S.ratti disease in human,not just the known S.stercoralis.It is likely to result in a certain proportion of people being infected by this animal-borne infectious pathogen.展开更多
Background:Despite the high prevalence of strongyloidiasis in the Laotian population,Laotian hospitals still lack diagnostic capacity to appropriately diagnose Strongyloides stercoralis infections.This cross-sectional...Background:Despite the high prevalence of strongyloidiasis in the Laotian population,Laotian hospitals still lack diagnostic capacity to appropriately diagnose Strongyloides stercoralis infections.This cross-sectional hospital-based study was conducted to assess the prevalence of Strongyloides stercoralis infection among hospitalized patients treated at Mahosot Hospital,the primary reference hospital of Lao People’s Democratic Republic(Lao PDR),and to validate feasible methods for diagnosing S.stercoralis infection at hospital’s laboratory.Methods:Between September and December 2018,stool samples of 104 inpatients were investigated for S.stercoralis infection by wet smear,Baermann technique,Koga Agar plate culture(KAPC),and real-time detection polymerase chain reaction(RTD-PCR)at the Infectious Diseases Ward of the Mahosot Hospital in Vientiane.The sensitivity,the specificity,the negative predictive value(NPV)of each diagnostic test,as well as their combination(s)was calculated using a composite reference standard(CRS).The correlation of the different test methods was assessed by chi-square or Fisher’s exact test.Cohen’s kappa coefficient was used to assess the diagnostic agreement of the different test methods.Results:The overall prevalence of S.stercoralis infections among the study population was 33.4%.The cumulative infection prevalence statistically significantly increased from the lowest age group of 40 years and below(22.4%),to the medium(40.0%)and to the oldest age group of 61 year and above(72.7%)(P=0.003).The cumulative infection prevalence of CRS was considerably higher in male(40.4%)compared to female patients(28.1%),but not statistically different(P=0.184).The diagnostic sensitivity of Baermann technique,KAPC,RTD-PCR,and the combination of Baermann technique and KAPC were 60.0,60.0,74.3,and 77.1%,respectively.Only 13 patients(37.1%)of the total 35 S.stercoralis patients diagnosed with any technique had a simultaneously positive diagnostic test with Baermann,KAPC and RTD-PCR.Conclusions:We ide展开更多
The symptoms of disseminated strongyloidiasis are not typical,and it is difficult for clinicians to identify strongyloidiasis in some non-endemic areas.We report a 70-year-old woman who was diagnosed with Guillain-Bar...The symptoms of disseminated strongyloidiasis are not typical,and it is difficult for clinicians to identify strongyloidiasis in some non-endemic areas.We report a 70-year-old woman who was diagnosed with Guillain-Barrésyndrome due to autonomic disturbance,symmetrical bulbar palsy,and lower-motor-nerve damage in the extremities;her symptoms continued to worsen after hormone and immunoglobulin therapy.Later,parasitic larvae were found in the patient’s gastric fluid,and metagenomic next generation sequencing(mNGS)detection of bronchoalveolar-lavage fluid also found a large number of Strongyloides roundworms.The patient was diagnosed with disseminated strongyloidiasis.The patient was given albendazole for anthelmintic treatment,but died two days after being transferred to the intensive care unit due to the excessive strongyloidiasis burden.In recent years,mNGS has been increasingly used in clinical practice,and is becoming the main means of detecting strongyloides stercoralis in non-endemic areas.Especially during the corona virus disease 2019 pandemic,mNGS technology has irreplaceable value in identifying the source of infection.展开更多
基金Supported in part by a grant from the Louis Albert FoundationTolosaArgentina(Grant No.G06 LM008655)
文摘Objective:To 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.Methods:The respiratory secretions submitted to the Parasitology Laboratory of the Mu(?)iz Hospital were made more concentrated by centrifugation(1 500 r/min for 15 seconds).Wet mount microscopy was performed with the pellet.Results:It 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.Conclusions:The 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.
文摘AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis(S.stercoralis)hyperinfection. METHODS:Over a period of 23 years(1984-2006),we investigated 25 patients withS.stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis.The clinical and endoscopic findings were analyzed retrospectively. RESULTS:Twenty-four(96%)of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1(HTLV-1)infection.The abnormal endoscopic findings,mainly edematous mucosa,white villi and erythematous mucosa,were observed in 23(92%) patients.The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy.The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative(Endoscopic severity score:4.86±2.47vs 2.71 ±1.38,P<0.05). CONCLUSION:Our study clearly demonstrates that,in addition to stool analysis,endoscopic observation and biopsies are very important.We also emphasize that S.stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.
文摘BACKGROUND Strongyloidiasis is usually a chronic infection but it can develop into a fatal disease in immunosuppressed patients.CASE SUMMARY A 68-year-old male with rheumatoid arthritis was treated with a variety of immunosuppressants for the past 3 years.Recently,the patient presented with a partial small-bowel obstruction,petechia,coughing and peripheral neuropathy.The diagnosis was difficult to clarify in other hospitals.Our hospital found Strongyloides stercoralis larvae with active movement in the routine stool and sputum smears.The diagnosis of disseminated strongyloidiasis was established.Ivermectin combined with albendazole was used for treatment.The patient responded to therapy and was discharged.CONCLUSION This case underscores the importance of comprehensive differential diagnosis in immunocompromised patients.
文摘Strongyloidiasis is endemic to the entire inter-tropical zone.Newly infected people are the most prone to experience the symptoms of this intestinal nematodosis.In this article,a 38-year old German citizen consulted for bowel movement disturbances and dyspepsia as well as diffuse and erratic pruritus,and was finally diagnosed with to have strongylodiasis is presented and discussed.
文摘Infections caused by Strongyloides stercoralis(S.stercoralis) in human are generally asymptomatic,however in immunocompromised individual,hyperinfection may develop with dissemination of larvae to extra-intestinal organs.The diagnosis could be easily missed due to asymptomatic presentation and insufficient exposure towards the infection itself,which may lead to low index of suspicion as a consequence.In this report,a case of a Malaysian male with underlying diabetes mellitus,hypertension,cerebrovascular accident,bullous pemphigus and syndrome of inappropriate antidiuretic hormone secretion who initially complained of generalized body weakness and poor appetite without any history suggestive of sepsis is presented.However,he developed septicemic shock later,and S.stercoralis larvae was incidentally found in the tracheal aspirate that was sent to look for acid fast bacilli.Regardless of aggressive resuscitation,the patient succumbed due to pulmonary hemorrhage and acute respiratory distress syndrome.It was revealed that the current case has alarmed us via incidental finding of S.stercoralis larvae in the tracheal aspirate,indicating that the importance of the disease should be emphasized in certain parts of the world and population respectively.
基金supported by Research Deputy of Hormozgan University of Medical Science(grant No.90/108/1977)
文摘Objective:To determine the prevalence of intestinal parasitic infections among mentally retarded residents of rehabilitation center of Bandar Abbas,Hormozgan province,southern Iran.Methods:A cross-sectional study was carried out in central rehabilitation institute of Hormozgan province in summer 2010.Fecal samples of all 133 residents(72 males,61 females)aged 3-52,were collected in triplicate.Specimens were examined by direct smear,formalin-ether concentration techniques and stained by permanent Trichrome,Ziehl-Neelsen stains.Statistical analysis was conducted by SPSS 13.5.Results:Intestinal parasitic infections were seen in 48.5%(64 out of 133 subjects:53.4%in males and 46.6%in females).Strongyloides stercoralis with17.3%showed the highest incidence followed by Entamoeba coli(9.8%),Blastocystis hominis(7.5%),Giardia lamblia(2.3%),Endolimax nana(2.3%),Hymenolepis nana(0.8%),Oxyuris vermicularis(0.8%),and Chilomasix mesnili(0.8%).Double infections were found to be as:Strongyloides stercoralis+Giardia lamblia(2.3%),Entamoeba coli+Giardia lamblia(1.5%),Entamoeba coli+Blastocystis hominis(1.5%),Oxyuris vermicularis+Entamoeba coli(0.8%),Strongyloides stercoralis+Entamoeba coli(0.8%),respectively.Conclusions:Our findings reveal that strongyloidiasis is a common disease among mentally retarded population in southern Iran.
文摘Background:Strongyloidiasis,a neglected disease caused by intestinal nematodes of the genus,is endemic to tropical and subtropical areas such as Vietnam.Morphological methods only identify the genus,while DNA-molecular techniques are susceptible in Strongyloides spp.detection.The study aims to determine the prevalence of dominant Strongyloides species among the population in Duc Hoa district,Long An,Vietnam.Methods:A cross-sectional study used 1190 stool specimens collected from July 2017 to November 2018.All samples were transported within 2 h,stored at 2-8℃,and processed within 48 h for microscopy smear and culture at the Laboratory of Medical Parasitology,Pham Ngoc Thach University of Medicine(PNT).Then all positive samples with the above 2 methods were verified by real-time PCR technique.Real-time PCR amplification was conducted at the Laboratory of Molecular Biology,PNT.Results:Direct microscopy and modified Harada-Mori culture detected Strongyloides spp.larvae in 79/1190 sam-ples(6.6%).About 94.2%of the DNA samples were Strongyloides stercoralis,2.9%were co-infections with Strongy-loides ratti and S.stercoralis,and 2.9%were patients with S.ratti.The identity of 12/14 sequences was confirmed as S.stercoralis with a high level of similarity(91.3%-100%)and over 98%for S.ratti.Conclusion:DNA-molecular techniques and sequence analysis are highly suitable for identifying Strongyloides species isolated from stool samples.It is remarkable evidence of the presence of zoonosis S.ratti disease in human,not just the known S.stercoralis.It is likely to result in a certain proportion of people being infected by this animal-borne infectious pathogen.
文摘Background:Despite the high prevalence of strongyloidiasis in the Laotian population,Laotian hospitals still lack diagnostic capacity to appropriately diagnose Strongyloides stercoralis infections.This cross-sectional hospital-based study was conducted to assess the prevalence of Strongyloides stercoralis infection among hospitalized patients treated at Mahosot Hospital,the primary reference hospital of Lao People’s Democratic Republic(Lao PDR),and to validate feasible methods for diagnosing S.stercoralis infection at hospital’s laboratory.Methods:Between September and December 2018,stool samples of 104 inpatients were investigated for S.stercoralis infection by wet smear,Baermann technique,Koga Agar plate culture(KAPC),and real-time detection polymerase chain reaction(RTD-PCR)at the Infectious Diseases Ward of the Mahosot Hospital in Vientiane.The sensitivity,the specificity,the negative predictive value(NPV)of each diagnostic test,as well as their combination(s)was calculated using a composite reference standard(CRS).The correlation of the different test methods was assessed by chi-square or Fisher’s exact test.Cohen’s kappa coefficient was used to assess the diagnostic agreement of the different test methods.Results:The overall prevalence of S.stercoralis infections among the study population was 33.4%.The cumulative infection prevalence statistically significantly increased from the lowest age group of 40 years and below(22.4%),to the medium(40.0%)and to the oldest age group of 61 year and above(72.7%)(P=0.003).The cumulative infection prevalence of CRS was considerably higher in male(40.4%)compared to female patients(28.1%),but not statistically different(P=0.184).The diagnostic sensitivity of Baermann technique,KAPC,RTD-PCR,and the combination of Baermann technique and KAPC were 60.0,60.0,74.3,and 77.1%,respectively.Only 13 patients(37.1%)of the total 35 S.stercoralis patients diagnosed with any technique had a simultaneously positive diagnostic test with Baermann,KAPC and RTD-PCR.Conclusions:We ide
文摘The symptoms of disseminated strongyloidiasis are not typical,and it is difficult for clinicians to identify strongyloidiasis in some non-endemic areas.We report a 70-year-old woman who was diagnosed with Guillain-Barrésyndrome due to autonomic disturbance,symmetrical bulbar palsy,and lower-motor-nerve damage in the extremities;her symptoms continued to worsen after hormone and immunoglobulin therapy.Later,parasitic larvae were found in the patient’s gastric fluid,and metagenomic next generation sequencing(mNGS)detection of bronchoalveolar-lavage fluid also found a large number of Strongyloides roundworms.The patient was diagnosed with disseminated strongyloidiasis.The patient was given albendazole for anthelmintic treatment,but died two days after being transferred to the intensive care unit due to the excessive strongyloidiasis burden.In recent years,mNGS has been increasingly used in clinical practice,and is becoming the main means of detecting strongyloides stercoralis in non-endemic areas.Especially during the corona virus disease 2019 pandemic,mNGS technology has irreplaceable value in identifying the source of infection.
