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A case of strongloidiasis with hyperinfection syndrome
Sung Jong Hong,Jin Shik Shin,* and Sun Young Kim**
Department of Parasitology, College of Medicine, Gyeong-Sang National University, ChinJu 660-280, Korea.
*Department of Internal Medicine, Jeil Hospital, Chinju 660-250, Gyengsang-do, Korea.
**Department of Clinical Pathology, Jeil Hospital, Chinju 660-250, Gyengsang-do, Korea.
Abstract
A 73-year-old Korean male was admitted to Jeil hospital with clinical complaints of backache, cough, sputum, vomiting and diarrhea. He had a history of long term administration of prednisolone. At admission he was comatose and showed generalized pitting edema and anasarca. Laboratory data revealed leukocytosis, hyperproteinemia with hypoalbuminemia, sepsis, anemia and brown-colored urine. Stool examination revealed rhabditiform nematode larvae. By fecal cultivation, filariform larvae of Strogyloides were obtained and the patient was diagnosed as hyperinfection syndrome due to S. stercoralis infection. On the 3rd day of hospitalization, albendazole treatment was started and continued for 4 days. On the 7th dsy of hospitalization, sputum revealed filariform larvae. Total 619 parasitic adult females, expelled by chemotherapy, were collected from the diarrheal stool. However, the patient was discharged hopelessly and died at home.
Figures
Figs. 1-4 Fig. 1. Rhabditiform larva of S. stercoralis from diarrheal stool showing rhabditiform esophagus, gut and genital primordium (GP). Bar=200µm.
Fig. 2a & b. Notched tail (arrow heads) of filariform larvae from fecal culture(a) and from sputum(b).Bar=50µm.
Fig. 3. Parasitic adult female of S. stercoralis collected from the diarrheal stool after the treatment with thiabendazole showing filariform esophagus(ESO), bipartite ovaries(OV) and vulvar opening(V). Bar=400µm.
Fig. 4. Intrauterine egg of parasitic adult female. Bar=100µm.
*Photographs were taken with differential interference contrast attachment except for Fig. 2a photographed in bright field.
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