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Candida and parasitic infection: Helminths, trichomoniasis, lice, scabies, and malaria
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The clinical effects of Strongyloides stercoralis infection include rash or pruritus (penetration phase); pneumonitis and cough (migration phase); and abdominal pain, diarrhea, nausea, and vomiting (intestinal phase) (31). Immunosup-pressed patients are at high risk from fulminant autoinfection. The drug of choice for treatment is ivermectin (200mg/kg/day orally × 2 days) with albendazole (400mg orally BID × 7 days) listed as an alternative. Strongyloidiasis in pregnancy may be left untreated until postpartum if symptoms are mild. Severe cases should be treated antepartum.
Strongyloidiasis
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Robert M. Genta, Peter D. Walzer
Strongyloides fulleborni von Listow, 1905 is a parasite of a variety of primates, but it may also infect humans. It was found in 34% of 76 infants in a village in Zaire, in 10% of 131 patients with strongyloidiasis in Zambia (7), and in 15-25% of villagers of the New Guinea highlands (8). Because of its high prevalence in primates in research facilities and zoos in the United States, S. fulleborni may represent an occupational hazard of animal caretakers (9).
Infections
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
The infection may be asymptomatic, or the cause of periodic skin itch. If the gut infection intensity builds up, it causes diarrhoea and weight loss. If there is massive infection (hyperinfection), it precipitates multiple organ failure with fulminant diarrhoea, septic shock, pneumonia, and meningitis, accompanied by a high blood eosinophil count. The sequelae of infection with Strongyloides sp. are indicated in Figure 20.57.
Utility of immunology, microbiology, and helminth investigations in clinical assessment of severe asthma
Published in Journal of Asthma, 2022
Andrew Singer, F. Runa Ali, Simon Quantrill, Nathan North, Mike Stevens, Jonathan Lambourne, Sofia Grigoriadou, Paul E. Pfeffer
Another concern is asymptomatic chronic Strongyloides infection. Strongyloides stercoralis is a parasite endemic to resource-poor tropical and subtropical regions, with an estimated global prevalence of 100 million cases (17). Strongyloides is almost unique amongst parasites in that it can complete its entire life-cycle within the human host and as a result chronic, often asymptomatic, infection can persist for decades after primary infection (17). Immune-mediated control of helminth infection is thought to rely on an intact Th2 immune response (18). With immune suppression, particularly with corticosteroids (19), there is an increased risk of developing hyper-infection, which carries a high mortality. This increased risk also hypothetically applies to anti-Th2 monoclonal antibody therapies. Concerns around the risk of hyper-infection, especially given the high prevalence of Strongyloides sero-positivity within the population that the hospital serves (20), led to introduction of screening patients for asymptomatic Strongyloides infection with an increasing volume of tests as the service grew.
Infectious diseases among Ethiopian immigrants in Israel: a descriptive literature review
Published in Pathogens and Global Health, 2021
Yulia Treister-Goltzman, Ali Alhoashle, Roni Peleg
The EI who came to Israel in 1991 stayed over in refugee camps in Addis Ababa with minimal medical services. In this population the prevalence of intestinal parasites was 75% with 25% having multiple parasites [60]. Severe, unique manifestations of intestinal helminths were described among EI. One 3-year-old boy had an acute abdomen following intestinal necrosis resulting from an intestinal obstruction by Ascaris lumbricoides [61]. Three unusual clinical cases of colonic schistosomiasis were reported in EI. One patient had bloody diarrhea for 3 years, the second had salmonella co-infection, and the third had schistosomal colitis that was found on routine sigmoidoscopy as part of screening [62]. Strongyloides is an intestinal nematode that infests millions of people in the developing world, but much fewer in the developed world. Infection can cause a fatal disease in immunosuppressed patients, sometimes following hyperinfection (accelerated autoinfection). Four cases of Strongyloidiasis in EI were reported from one medical center in Israel over a one-year period. They had different manifestations of severe infection that were seen in the gastrointestinal tract and the lungs with further dissemination to other body systems. Three of these cases ended in death [63].
Assessing and mitigating risk of infection in patients with multiple sclerosis on disease modifying treatment
Published in Expert Review of Clinical Immunology, 2021
Susana Otero-Romero, Adrián Sánchez-Montalvá, Angela Vidal-Jordana
The initial assessment should cover medical, travel, sexual, vaccine and previous infections history, including prior tuberculosis (TB) history or contact, and prior immunosuppressive history. Blood sample tests should include a serological assessment testing for at least: VZV, measles, mumps, rubella, hepatitis A, B and C virus (HAV, HBV, HCV), and human immunodeficiency virus (HIV). Additionally, cytomegalovirus (CMV), EBV, HPV, JCV, and TB screening is also recommended specially when planning to start some specific treatments [7,12] (Table 1). Use of a standardized questionnaire may help to guide the initial screening (Figure 1). Attending to country of origin and travel history, patients living for more than 3 months in Latin America should be tested for Trypanosoma cruzi infection. Patients living for more than 3 months in Sub-Saharan African should be tested for Schistosoma species (spp.) and malaria (preferably by molecular biology tests), other malaria-endemic and schistosoma-endemic areas of the world should also be included. All patients living for more than 3 months in middle – or low-income countries should consider Strongyloides spp. serology (IgG) and microscopic examination of the stools.