Year 2024 / Volume 116 / Number 10
Letter
Strongyloides stercoralis hyperinfection presenting pneumatosis intestinalis and acute respiratory distress syndrome after treatment for COVID-19

574-575

DOI: 10.17235/reed.2024.10292/2024

Maki Setake, Kazuhiko Matsuno, Kyoko Arakaki, Akira Hokama,

Abstract
A 91-year-old man was admitted with vomiting and abdominal pain. He had had COVID-19 pneumonia a month before and the treatment had consisted of remdesivir, dexamethasone and baricitinib. CT scans showed pneumatosis intestinalis. His respiratory condition rapidly deteriorated and chest CT scans showed ground-glass opacity and Strongyloides stercoralis was identified in the sputum, making a diagnosis of hyperinfection syndrome associated acute respiratory distress syndrome. Treatment of ivermectin was not achieved in time and he died of multiple organ failure. S. stercoralis is a soil-transmitted helminth endemic to tropical and subtropical areas. Immunosuppressive conditions can cause hyperinfection syndrome and life-threatening conditions. Our case highlights the importance of assessing for untreated chronic strongyloidiasis in COVID-19 patients requiring steroid treatment in endemic areas.
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References
1. Czeresnia JM, Weiss LM. Strongyloides stercoralis. Lung 2022;200:141-8.
2. Tanaka T, Hirata T, Parrott G, et al. Relationship among Strongyloides stercoralis infection, human T-cell lymphotropic virus type 1 infection, and cancer: A 24-year cohort inpatient study in Okinawa, Japan. Am J Trop Med Hyg 2016;94:365-70.
3. Seeger D, Cornejo Cisneros E, Lucar J, et al. Strongyloides and COVID-19: Challenges and opportunities for future research. Trop Med Infect Dis 2023;8:127.
4. Hokama A, Tomiyama R. Ulcerative colitis exacerbated by strongyloidiasis. Rev Esp Enferm Dig 2023;115:102-3. 10.17235/reed.2022.9044/2022
5. Lorenzo H, Carbonell C, Vicente Santiago MB, et al. Influence of the drugs used in migrant patients with severe acute respiratory syndrome coronavirus 2 and the development of symptomatic strongyloidiasis. Trans R Soc Trop Med Hyg 2022;116:440-5.
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Setake M, Matsuno K, Arakaki K, Hokama A. Strongyloides stercoralis hyperinfection presenting pneumatosis intestinalis and acute respiratory distress syndrome after treatment for COVID-19 . 10292/2024


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Publication history

Received: 22/01/2024

Accepted: 31/01/2024

Online First: 12/02/2024

Published: 09/10/2024

Article Online First time: 21 days

Article editing time: 261 days


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