Strongyloides stercoralis hyperinfection: a dreaded but still missed diagnosis

Ano: 2012 | Volume: 2 | Número: 3

Autores: M. R. F. Crenitte, F. P. F. Campos, A. Felipe-Silva

Palavras-chave: strongyloides stercoralis, glucocorticoids, immunocompromised host, shock septic.

Resumo Inglês:

Strongyloides stercoralis (S. stercoralis), an intestinal nematode, is endemic
in tropical and subtropical regions, being less prevalent in temperate climates.
The number of infected persons worldwide ranges between 10 million and
100 million people. In Brazil the reported prevalence is 13%. Chronic infection
may be asymptomatic or accompanied by gastrointestinal and respiratory
symptoms. Under immunosuppressive conditions, the infection assumes
serious proportions frequently accompanied by septic shock, disseminated
intravascular coagulopathy and respiratory distress syndrome. The authors
report a case of a 50-year-old female patient who was a chronic user of
glucocorticoids and had been seeking medical attention for two months
because of continuous gastrointestinal symptoms. She was admitted to the
emergency room with clinical signs of septic shock and died after four days
despite an adequate antibiotic regimen, vasopressor drugs, and ventilatory
support. The autopsy revealed the unsuspected finding of S. stercoralis
hyperinfection and septicemia.