Abstract
Rationale: Strongyloidiasis is a chronic parasitic infection caused by Strongyloides stercoralis and is recognized as “neglected tropical disease”. Therefore, diagnosis of the infection may become problematic in non-endemic areas of the globalized society. Because severe strongyloidiasis often involves pulmonary manifestations, we reason that pulmonary manifestations are noteworthy characteristics in the diagnosis of strongyloidiasis. Here, we present observations of pulmonary manifestations in cases of severe strongyloidiasis.
Methods: Our retrospective study included all patients with severe strongyloidiasis diagnosed in Ryukyu University Hospital and affiliated hospitals in Okinawa, Japan, from January 2004 to December 2014. All diagnoses were confirmed by the microscopic identification of S. stercoralis larvae. Severe infection was defined as 1) the identification of S. stercoralis from extra gastrointestinal specimens, 2) sepsis, 3) meningitis, 4) acute respiratory failure or 5) respiratory tract hemorrhage. Medical records were reviewed to extract related clinical features.
Results: In total 17 severe Strongyloidiasis cases were collected. The mean age of patients was 74.9 years. Sixteen cases had pulmonary manifestations, 8 with bacterial pneumonia, 8 with ARDS and 5 with respiratory hemorrhage. Chest CT was performed in 5 cases and all findings showed bilateral ground glass opacities and consolidation with interlobular septal thickening.
Conclusion: Severe strongyloidiasis tends to develop some type of pulmonary manifestation; bacterial pneumonia, ARDS and respiratory hemorrhage are common. CT findings from all cases showed same pattern regardless of their pulmonary manifestations.
- Copyright ©ERS 2015