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International Medical Case Reports... 2024We report a fatal case of massive airway bleeding caused by pulmonary strongyloidiasis in a patient with a transplanted kidney.
INTRODUCTION
We report a fatal case of massive airway bleeding caused by pulmonary strongyloidiasis in a patient with a transplanted kidney.
CASE PRESENTATION
A 47-year-old male, regularly taking immunosuppressants post-kidney transplant, visited our hospital with symptoms of abdominal bloating, nausea, and emesis persisting for three days. After hospitalization, he developed a cough, hemoptysis, and respiratory failure. Sputum analysis confirmed an infestation with Strongyloides stercoralis. Despite receiving albendazole therapy and bronchoscopic management for bronchial hemorrhage, the patient ultimately died due to acute respiratory and circulatory collapse triggered by severe airway bleeding.
CONCLUSION
Patients undergoing immunosuppressive therapy following kidney transplantation are at increased risk for disseminated strongyloidiasis. Consequently, infectious disease screening prior to transplantation, along with essential preventive pharmacotherapy, is of paramount importance.
PubMed: 38196944
DOI: 10.2147/IMCRJ.S442535 -
Acta Tropica Mar 2024Gastrointestinal protist (GP) and soil-transmitted helminth (STH) infections cause significant morbidity among children in poor-resource settings of tropical and...
Gastrointestinal protist (GP) and soil-transmitted helminth (STH) infections cause significant morbidity among children in poor-resource settings of tropical and sub-tropical countries including Colombia. Few prospective transversal studies investigating how GP and STH infections affect growth development and nutritional status during childhood have been conducted in this country, none of them in the Antioquia Department. This microscopy-based study estimated the prevalence of GP and helminth (including STH) infections in faecal samples from schoolchildren (n = 384) collected during April-May 2019 in three municipalities of the Antioquia Department. Demographic, epidemiological, and household data were elicited through face-to-face interviews. Parasite detection was carried out by direct microscopic examination of both fresh smears and concentrated faecal material. Children (aged 6-15 years) also had their haemoglobin (Hb) levels, height and weight data collected, and BMI estimated. Data were analysed using bivariate and multivariate logistic regression analysis. Overall, 60.7 % (233/384) of schoolchildren were infected by at least one intestinal parasitic species. Among GPs, Blastocystis sp. was the most common species found (47.7 %, 95 % CI: 42.6-52.8), followed by G. duodenalis (15.9 %, 95 % CI: 12.4-19.9). Cryptosporidium spp. and Cyclospora cayetanensis were sporadically identified (0.3 %, 95 % CI: 0.1-1.4 each). Among helminths, the most prevalent species found were Trichuris trichiura (6.0 %, 95 % CI: 3.8-8.9) and Enterobius vermicularis (1.0 %, 95 % CI: 0.3-2.6). Hookworms, Ascaris lumbricoides, and Strongyloides stercoralis were found at prevalence rates <1 %. Underweight, overweigh, or obese schoolchildren had 1.2 times greater chance of being infected with intestinal parasites than their counterparts with a healthy weight (P-value: 0.015). Variables significantly associated with an increased likelihood of being infected by intestinal parasites include living in a household with unfinished flouring, not wearing shoes, being in close proximity to rodents, and having improper waste disposal. Relatively simple interventional measures directed towards the improvement of household conditions, access to sanitary toilets, and promoting shoe wearing can significantly reduce childhood infections by GP and helminths in the Antioquia Department.
Topics: Humans; Child; Animals; Cryptosporidiosis; Nutritional Status; Colombia; Prospective Studies; Cryptosporidium; Intestinal Diseases, Parasitic; Helminthiasis; Helminths; Parasites; Soil; Feces; Prevalence
PubMed: 38195005
DOI: 10.1016/j.actatropica.2024.107119 -
The American Journal of Tropical... Feb 2024Strongyloidiasis, caused by Strongyloides stercoralis, is a neglected tropical disease with a global distribution. The infection can be fatal in immunocompromised...
Strongyloidiasis, caused by Strongyloides stercoralis, is a neglected tropical disease with a global distribution. The infection can be fatal in immunocompromised individuals, and accurate diagnosis leading to timely treatment can save lives. Serodiagnosis is a sensitive method for diagnosis and is recommended for screening high-risk individuals. A point-of-care rapid test will facilitate the screening activities, especially in low-resource settings. This study aims to apply a new IgG4 immunochromatographic test using S. stercoralis recombinant antigen (SsRapid® cassette test) and to compare it with in-house IgG and IgG4 enzyme-linked immunosorbent assays (IgG- and IgG4-ELISAs) using native Strongyloides ratti antigen to investigate the epidemiology of strongyloidiasis in northeast Thailand. A total of 300 people participated, with 136 males and 164 females of a similar mean age. The reference tests were fecal examinations using the formalin-ethyl acetate concentration technique and an agar plate culture technique. The prevalence of S. stercoralis determined by SsRapid (81.7%) was significantly higher than that by fecal examinations (43.3%) or by antibody detection by IgG-ELISA (53.0%) or IgG4-ELISA (44.0%). The diagnostic sensitivities of SsRapid, IgG-ELISA, and IgG4-ELISA were found to be 93.9%, 77.7%, and 63.1%, respectively. The rate of positive tests by the SsRapid was significantly correlated to the levels of Strongyloides-specific IgG4 and IgG antibodies. By all diagnostic methods, male participants had a significantly higher prevalence of strongyloidiasis than females. Age was significantly associated with the concentration of specific serum IgG but not with the SsRapid grading score. In conclusion, SsRapid was shown to be a sensitive and valuable diagnostic test for the epidemiology study of strongyloidiasis.
Topics: Humans; Animals; Female; Male; Strongyloidiasis; Immunoglobulin G; Thailand; Antibodies, Helminth; Strongyloides stercoralis; Serologic Tests; Enzyme-Linked Immunosorbent Assay; Feces
PubMed: 38190756
DOI: 10.4269/ajtmh.23-0518 -
Parasitology Mar 2024Some serology assays demonstrated useful for post-treatment monitoring of infection. Serology frequently has low specificity, which might be improved by the use of... (Randomized Controlled Trial)
Randomized Controlled Trial
Some serology assays demonstrated useful for post-treatment monitoring of infection. Serology frequently has low specificity, which might be improved by the use of recombinant antigens. The Strongy Detect ELISA is based on 2 recombinant antigens (SsIR and NIE) and proved good accuracy. Aim of this study was to evaluate the performance of this test for the post-treatment monitoring of strongyloidiasis. We tested 38 paired sera, with matched fecal tests results, stored in our biobank and originating from a randomized controlled trial. At baseline, all patients tested positive for at least 1 fecal assay among PCR, direct stool microscopy and agar plate culture. Patients were re-tested with both serology and fecal assays 12 months after treatment. Primary outcome was the relative reduction in optical density (OD) between baseline and follow up. We observed that about 95% samples showed a reduction between pre and post-treatment OD, with a median relative reduction of 93.9% (IQR 77.3%–98.1%). In conclusion, the test proved reliable for post-treatment monitoring. However, some technical issues, including that the threshold for positivity has not be predefined, and that a substantial number of samples showed overflow signals, need to be fixed to permit use in routine practice.
Topics: Animals; Humans; Strongyloides stercoralis; Follow-Up Studies; Antibodies, Helminth; Strongyloidiasis; Enzyme-Linked Immunosorbent Assay; Sensitivity and Specificity
PubMed: 38185819
DOI: 10.1017/S0031182024000027 -
Topics in Companion Animal Medicine 2024Canine strongyloidosis by Strongyloides stercoralis is a parasitic disease emerging in Europe, which represents both a veterinary clinical issue and a public health...
Canine strongyloidosis by Strongyloides stercoralis is a parasitic disease emerging in Europe, which represents both a veterinary clinical issue and a public health challenge because of the zoonotic potential. The disease, not yet frequent in Europe, could induce severe clinical signs in dogs; thus, an early diagnosis and appropriate treatment are desirable. The aim of the present work is to retrospectively investigate the clinical and paraclinical findings in sick dogs naturally infected by S. stercoralis, with particular attention to ultrasound (US) changes at the gastrointestinal level. Twelve dogs were included in the study. The diagnosis was made by means of larval morphological identification on faecal samples and PCR. Most dogs presented with gastrointestinal signs; diarrhea and weight loss were the most common presenting complaint. Only one dog showed respiratory signs, associated to a parasitic cutaneous nodule. Hypoproteinaemia, anaemia, leucocytosis and an increase in alpha2-globulin fraction at serum protein electrophoresis were common (>50%) but not constant findings. The most reported US picture was a fluid-filled, distended, atonic small intestine mostly associated with altered wall layering, while the wall thickness commonly associated with chronic enteritis was only rarely reported. These changes, associated with other clinical and paraclinical alterations, could increase the suspicion of canine strongyloidosis and may direct clinicians to include strongyloidosis in the differential diagnosis of dogs with diarrhea. The histological examination at the intestinal level, available in five dogs, revealed the presence of parasites from the full-thickness biopsy, but not from the endoscopic biopsy. The critical points of diagnosis in clinical practice are also discussed.
Topics: Animals; Dogs; Dog Diseases; Strongyloidiasis; Male; Female; Retrospective Studies; Feces; Strongyloides stercoralis; Ultrasonography; Diarrhea
PubMed: 38184143
DOI: 10.1016/j.tcam.2024.100845 -
Journal of Parasitology Research 2023Gastrointestinal parasites cause health problems and even death in captive animals. These animals are more susceptible to parasitic infestations because of confinement...
Gastrointestinal parasites cause health problems and even death in captive animals. These animals are more susceptible to parasitic infestations because of confinement and stress. The aim of the study is to describe parasitic causal agents in captive wild animals at the Bangladesh National Zoo, Chittagong Zoo, and Tilagarh Eco Park, in Sylhet. A total of 54 fecal samples were collected from the Bangladesh Zoo, Chittagong Zoo, and Tilagarh Eco Park from April 2022 to November 2022. Samples were collected from animals of the groups Aves (16), Reptiles (4), Artiodactyla (23), Perissodactyla (8), and Proboscidea (3). All samples were examined using a modified formalin ether sedimentation technique. Fecal examination consoled an overall occurrence of 61.1%. Out of 54 samples, 33 were positive for parasitic infection. The parasites observed were as follows: Ascarididae eggs (57.58%), spp. (18.18%), spp. (9.09%), spp. (6.06%), and mixed infection (9.09%). The order Reptiles had a 100% infection rate, while Aves had the lowest infection rate (50%). Only nematodes were detected in this study. Without showing evident, clinical signs and symptoms of disease, the prevalence of gastrointestinal parasites is high. This indicates a subclinical infection. This study shows that more epidemiological research and sanitation management programs, including regular antihelminthic therapy for controlling parasitic infection, should be adopted in zoos and ecoparks.
PubMed: 38179198
DOI: 10.1155/2023/3692471 -
Frontiers in Bioscience (Elite Edition) Nov 2023Helminthiases inflict annual losses on the meat and dairy livestock industries. The commonest species of ruminant parasites are the nematodes: and , which lay eggs in...
BACKGROUND
Helminthiases inflict annual losses on the meat and dairy livestock industries. The commonest species of ruminant parasites are the nematodes: and , which lay eggs in the intestine and enter the feces. There, the eggs develop into larvae, which when voided with the feces crawl onto plants.
METHODS
In our experiment, we evaluated the survivability of the noninvasive and invasive (L1-2 and L3, respectively) larvae of , (L3), and (L1) by subjecting each to natural compounds present in the essential oils of many plants. In the experiment, we used aqueous emulsions of eugenol, isoeugenol, thymol, and carvacrol.
RESULTS
Administering 1% concentrations of those compounds killed 100% of the nematode larvae following 24 h of exposure. Thymol, eugenol, and isoeugenol at a concentration of 0.1% also caused high larvae mortality (over 96%).
CONCLUSIONS
Continuous usage of synthetic anthelmintic drugs in veterinary medicine has led to the parasites developing resistance, thus, a search for novel nematicidal drugs is required. Eugenol, isoeugenol, thymol, and carvacrol are promising compounds against nematodes. However, additional research is required regarding peculiarities in their actions toward the bodies of mammals and parasitic nematodes.
Topics: Animals; Thymol; Eugenol; Nematoda; Larva; Mammals
PubMed: 38163936
DOI: 10.31083/j.fbe1504025 -
Parasitology International Jun 2024Strongyloides stercoralis is a zoonotic soil-transmitted nematode affecting mainly humans and dogs but identified also in non-human primates, cats and wild carnivores....
Strongyloides stercoralis is a zoonotic soil-transmitted nematode affecting mainly humans and dogs but identified also in non-human primates, cats and wild carnivores. It has a cosmopolitan distribution being endemic in tropical and subtropical areas. In Romania, the infection was reported on several occasions in dogs with low prevalence (3.5% -3.8%), assessed by coproscopy and it was confirmed in human patients with no travel history. A 2-year-old male Boston Terrier dog presented to a private clinic due to severe digestive problems, in July 2022. The animal had a long history of health problems. The dog was in a very bad clinical condition with severe abdominal pain, bloody diarrhea, and weight loss. Coproparasitological examinations using the saline flotation method and the modified Baermann's technique were done, both being negative. In addition, an intestinal biopsy was performed during the second endoscopy. Nematodes were collected and identified morphologically and molecularly confirmed. Histology revealed severe inflammation of the duodenal mucosa with areas of edema, necrosis, and hemorrhage, and in the intestinal glands, there were numerous nematodes suggesting a parasitic infection by Strongyloides spp. PCR followed by sequencing confirmed the infection with S. stercoralis. The dog was treated with a combination of oral fenbendazole and milbemycin oxime for 5 months. No relapse was observed 3 months after negativity was attained. This case describes a severe clinical infection by Strongyloides stercoralis in a domestic dog from Romania and the recovery after long-term treatment.
Topics: Humans; Male; Dogs; Animals; Strongyloides stercoralis; Strongyloidiasis; Romania; Feces; Diarrhea
PubMed: 38151172
DOI: 10.1016/j.parint.2023.102849 -
Heliyon Jan 2024Pulmonary strongyloidiasis is a rare infection in patients with autoimmune diseases, and immunosuppression can lead to the development of hyperinfection syndrome with a...
Pulmonary strongyloidiasis is a rare infection in patients with autoimmune diseases, and immunosuppression can lead to the development of hyperinfection syndrome with a high mortality rate. We present a case of a 78-year-old male with previous idiopathic inflammatory myopathy (IIM) with interstitial lung disease. He developed hyperinfection syndrome and respiratory failure, and diagnostic metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) confirmed the presence of . After treatment with ivermectin, the patient's symptoms improved. Therefore, adequate screening and prophylactic treatment are needed for people at risk of immunosuppression, which can reduce the occurrence of the devastating hyperinfection syndrome. It also highlights mNGS as a highly accurate test for the detection of difficult to atypical pathogens.
PubMed: 38148807
DOI: 10.1016/j.heliyon.2023.e23484