Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome
Strongyloides stercoralis is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of Strongyloides hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF-α inh...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2018/6341680 |
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| author | Muhammad Farhan Khaliq Rayan E. Ihle James Perry |
| author_facet | Muhammad Farhan Khaliq Rayan E. Ihle James Perry |
| author_sort | Muhammad Farhan Khaliq |
| collection | DOAJ |
| description | Strongyloides stercoralis is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of Strongyloides hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF-α inhibitors. Despite aggressive treatment including broad-spectrum antibiotics and antihelminths, his respiratory failure worsened and he died after palliative extubation. S. stercoralis infection remains a diagnostic challenge. Presentation with Strongyloides is often nonspecific, and eosinophilia is absent in hyperinfection. Diagnosis can be delayed, especially in low-prevalence areas where suspicion is low. Strongyloides should be considered in the differential diagnosis in the presence of risk factors including immunosuppressive therapy, and a travel history should be carefully obtained. Patients with recurrent enterobacterial sepsis or respiratory failure with diffuse infiltrates in the setting of eosinophilia should undergo testing for Strongyloides. A multidisciplinary approach can result in earlier diagnosis and favorable outcomes. |
| format | Article |
| id | doaj-art-fc3decbd4e9841b9b7df835549528506 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-fc3decbd4e9841b9b7df8355495285062025-02-03T01:29:54ZengWileyCase Reports in Infectious Diseases2090-66252090-66332018-01-01201810.1155/2018/63416806341680Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection SyndromeMuhammad Farhan Khaliq0Rayan E. Ihle1James Perry2Department of Internal Medicine, Charleston Area Medical Center, Charleston, WV, USADepartment of Pulmonary Critical Care, West Virginia University Charleston Division, Charleston, WV, USADepartment of Pulmonary Critical Care, Charleston Area Medical Center, Charleston, WV, USAStrongyloides stercoralis is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of Strongyloides hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF-α inhibitors. Despite aggressive treatment including broad-spectrum antibiotics and antihelminths, his respiratory failure worsened and he died after palliative extubation. S. stercoralis infection remains a diagnostic challenge. Presentation with Strongyloides is often nonspecific, and eosinophilia is absent in hyperinfection. Diagnosis can be delayed, especially in low-prevalence areas where suspicion is low. Strongyloides should be considered in the differential diagnosis in the presence of risk factors including immunosuppressive therapy, and a travel history should be carefully obtained. Patients with recurrent enterobacterial sepsis or respiratory failure with diffuse infiltrates in the setting of eosinophilia should undergo testing for Strongyloides. A multidisciplinary approach can result in earlier diagnosis and favorable outcomes.http://dx.doi.org/10.1155/2018/6341680 |
| spellingShingle | Muhammad Farhan Khaliq Rayan E. Ihle James Perry Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome Case Reports in Infectious Diseases |
| title | Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome |
| title_full | Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome |
| title_fullStr | Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome |
| title_full_unstemmed | Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome |
| title_short | Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome |
| title_sort | immunosuppression with antitumour necrosis factor therapy leading to strongyloides hyperinfection syndrome |
| url | http://dx.doi.org/10.1155/2018/6341680 |
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