Pulmonary strongyloidiasis: assessment between manifestation and radiological findings in 16 severe strongyloidiasis cases
| Autor: | Teruhisa Tanaka, Akira Hokama, Shusaku Haranaga, Gretchen Parrott, Daijiro Nabeya, Takeshi Kinjo, Saifun Nahar, Masao Tateyama, Jiro Fujita, Tetsuo Hirata |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Lung Diseases Male medicine.medical_specialty Pathology ARDS 030231 tropical medicine Hemorrhage Pulmonary alveolar hemorrhage Gastroenterology lcsh:Infectious and parasitic diseases Strongyloides stercoralis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Animals Humans lcsh:RC109-216 Aged Retrospective Studies Aged 80 and over Respiratory Distress Syndrome Acute respiratory distress syndrome biology business.industry Bacterial pneumonia Middle Aged Interlobular septal thickening pulmonary strongyloidiasis medicine.disease biology.organism_classification Pneumonia Infectious Diseases Strongyloidiasis 030228 respiratory system Larva Respiratory Tract Hemorrhage Pulmonary Alveolar Hemorrhage Female Pulmonary hemorrhage business Research Article |
| Zdroj: | BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-9 (2017) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-017-2430-9 |
| Popis: | Background Strongyloidiasis is a chronic parasitic infection caused by Strongyloides stercoralis. Severe cases such as, hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), can involve pulmonary manifestations. These manifestations frequently aid the diagnosis of strongyloidiasis. Here, we present the pulmonary manifestations and radiological findings of severe strongyloidiasis. Methods From January 2004 to December 2014, all patients diagnosed with severe strongyloidiasis at the University of the Ryukyus Hospital or affiliated hospitals in Okinawa, Japan, were included in this retrospective study. All diagnoses were confirmed by the microscopic or histopathological identification of larvae. Severe strongyloidiasis was defined by the presence of any of the following: 1) the identification of S. stercoralis from extra gastrointestinal specimens, 2) sepsis, 3) meningitis, 4) acute respiratory failure, or 5) respiratory tract hemorrhage. Patients were assigned to either HS or DS. Medical records were further reviewed to extract related clinical features and radiological findings. Results Sixteen severe strongyloidiasis cases were included. Of those, fifteen cases had pulmonary manifestations, eight had acute respiratory distress syndrome (ARDS) (53%), seven had enteric bacterial pneumonia (46%) and five had pulmonary hemorrhage (33%). Acute respiratory failure was a common indicator for pulmonary manifestation (87%). Chest X-ray findings frequently showed diffuse shadows (71%). Additionally, ileum gas was detected for ten of the sixteen cases in the upper abdomen during assessment with chest X-ray. While, chest CT findings frequently showed ground-glass opacity (GGO) in 89% of patients. Interlobular septal thickening was also frequently shown (67%), always accompanying GGO in upper lobes. Conclusions In summary, our study described HS/DS cases with pulmonary manifestations including, ARDS, bacterial pneumonia and pulmonary hemorrhage. Chest X-ray findings in HS/DS cases frequently showed diffuse shadows, and the combination of GGO and interlobular septal thickening in chest CT was common in HS/DS, regardless of accompanying pulmonary manifestations. This CT finding suggests alveolar hemorrhage could be used as a potential marker indicating the transition from latent to symptomatic state. Respiratory specimens are especially useful for detecting larvae in cases of HS/DS. |
| Databáze: | OpenAIRE |
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