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Strongyloides Hyperinfection: An Unusual Cause of Respiratory Failure
- Faris Khasawneh, MD;
- Radhika Sreedhar, MD; and
- Vishnu Chundi, MD
- From St. Joseph Hospital, Fort Wayne, IN 46802, and Westlake Hospital, Melrose Park, IL 60160.
Background: Infection with Strongyloides stercoralis may present with symptoms of asthma or chronic obstructive pulmonary disease (COPD) (1). However, use of steroids in a wheezing patient with chronic strongyloides may trigger disseminated strongyloides infection (1, 2). In this case, steroid-induced immunosuppression triggered strongyloides hyperinfection in a chronically infected patient.
Case Report: A 71-year-old woman presented with a 3-day history of shortness of breath associated with nonproductive cough and fever (temperature, 101.2 °F).
Her medical history included stroke with subsequent aphasia, dysphagia, and dementia. She had a history of recurrent small-bowel obstructions secondary to adhesions resulting from a hysterectomy. She is a native of South America and now lives in a long-term care facility in the midwestern United States.
Physical examination showed tachypnea, bibasilar crepitations, and diffuse end expiratory wheezes. Chest radiography showed patchy infiltrates in the left lower lung field with slight hyperaeration suggestive of COPD. She …
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