Strongyloidiasis following long-term corticosteroid therapy
Yamori, S.; Yamamoto, M.; Kawabata, A.; Nakashima, K.; Iinuma, Y.; Satake, T.; Shimokata, K.
Nihon Kyobu Shikkan Gakkai Zasshi 27(10): 1226-1230
1989
ISSN/ISBN: 0301-1542 PMID: 2615077 Document Number: 345600
A 64-year-old man who was born and raised in Fukuoka Prefecture was admitted because of dyspnea. The chest X-ray film showed multiple pulmonary cysts. Corticosteroid therapy was given because of repeated episodes of dyspnea and wheezing. He complained of epigastric pain 20 months after administration of corticosteroid therapy. Gastro-endoscopic examination showed inflammatory changes of the gastric mucosa and the biopsy specimens revealed the filariform larvae of Strongyloides stercoralis. Furthermore, the larvae were frequently detected in both sputum specimens and stools. Pyrvinium pamoate was initially administered and was switched to thiabendazole because of the presence of hyperinfection. Although two cycles of thiabendazole treatment were given, the larvae were not eradicated. This case report suggests that long term corticosteroid therapy caused the hyperinfection syndrome of Strongyloides stercoralis in a patient who was auto-infected with this nematode.