• Parasites, Hosts and Diseases
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• 제26권3호
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• pp.221-226
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• 1988

면역기능이 저하된 한국인 73세 남자가 요통을 주소로 입원하였다. 환자는 prednisolone 을 장기간 투여하였다고 하며 입원시 전신성 pitting edema와 기침, 객담, 구토, 설사를 하였고 빈 사상태였다. 백혈구는 증가하였으나 초산구중가증은 없었으며 저 단백혈증, hypoalbuminemia, 패혈증, 빈혈이 있었다. 뇨는 한색이었다. 대변검사에서 rhabditiform 유충이 관찰되었으며 대변 배양 검사로 분선충의 filariform유충이 확인되어 분선충에 의한 hyperinfection으로 진단되었다. 치료목적으로 입원 제3일부터 albendazole을 4일간 투여하였다. 입원 제7일에 객담검사에서 filariform유충이 관찰되었으며 설사변에서 분선충의 기생세대 자충 619마리를 수집하였다. 그러나 환자는 희망없이 빈사상태로 퇴원하였으며 얼마 후 자택에서 사망하였다.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.200-203
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• 2018

Strongyloides stercoralis is an intestinal nematode that occurs sporadically in temperate areas like Korea. People who are in the immunosuppressed state, over the age of 65 or under the corticosteroid therapy are at risk for developing Strongyloides hyperinfection syndrome. Acute respiratory distress syndrome (ARDS) with alveolar hemorrhage is a rare presentation of Strongyloides hyperinfection. A 78-year-old man had been irregularly injected corticosteroid on his knees, but did not have any immunosuppressive disease. He was initially diagnosed with ARDS and septic shock. Bronchoalveolar lavage (BAL) fluid was bloody and its cytology revealed helminthic larvae identified as S. stercoralis. Results of Cytomegalovirus polymerase chain reaction (PCR), Pneumocystis jirovecii PCR, and Aspergillus antigen testing of the BAL fluid were positive. The clinical progress quickly deteriorated with multiple organ failure, shock and arrhythmia, so he finally died. This is a rare case of ARDS in an older patient without any known immunosuppressive conditions, with alveolar hemorrhage and S. stercoralis being found via BAL.

• 한국임상수의학회지
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• 제38권4호
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• pp.210-212
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• 2021

A 10-year-old spayed female beagle referred to the Veterinary Teaching Hospital of Chungnam National University presented with acute diarrhea, depression, anorexia, and emaciation. The laboratory findings of the dog showed leukocytosis, high C-reactive protein, and low albumin levels. Fecal examinations revealed severe infection with Strongyloides (S.) stercoralis, with a high fecal score (6/7). Consequently, the dog was diagnosed with hyperinfection of S. stercoralis, and thus, was treated with fenbendazole and ivermectin after discontinuation of prednisolone treatment. The dog showed negative on the Fecal Dx^® Antigen Panel (IDEXX Laboratories Inc., Westbrook, ME, USA) after treatment, and clinical signs disappeared with normal stool consistency.

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.518-524
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• 1993

저자 등은 만성질환으로 인해 영양결핍 및 면역저하상태로 생각되는 75세 폐결핵환자에서 분선충의 대량의 자가감염을 객담, 분변에서 확인하여 치료하였으나 사망한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.307-311
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• 2016

Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy.

• Parasites, Hosts and Diseases
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• 제43권2호
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• pp.51-55
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• 2005

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured $269\pm21.2{\mu}m$ in length and $11\pm0.6{\mu}m$ in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.

• Parasites, Hosts and Diseases
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• 제23권2호
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• pp.236-240
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• 1985

A case of Strongyloides stercoralis infection was experienced in a 73-year old Korean female patient, was hospitalized with relapse of cholecystitis. The patient developed cough and dyspnea 17 days after the admission. On the 27th hospitalized day, diarrhoea, nausea, vomiting and abdominal pain started. A number of parasitic larvae were incubated at $25^{\circ}C$ for 2 days. Typical fork tailed filariform larvae of S. stercoralis (Bavay, 1876) Stiles and Hassall, 1902, were identified after cultivation. There was no improvement of diarrhoea after the medication with mebendasole. After the administration of thiabendazole, however, diarrhoea was stopped. On the 6th day of medication, S. stercoralis larvae was no more detected, and thereafter no larva was observed by repeated stool examinations upto 2 months after chemotherapy. The patient had the history of administration of steroid for articular rheumatism. Therfore this ,case seems to be a hyperinfection of S. stercoralis due to an autoinfection and to be the first report on the hyperinfected strongyloidiasis in Korea. Related literature was briefly reviewed.

• Parasites, Hosts and Diseases
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• 제32권1호
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• pp.49-52
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• 1994

1990년 4월부터 1992년 2월까지 인제대 부속 서울 백병원과 상계 백병원에 내원한 환자 중 대변에서 분선충(Strongwloides stercoralis)의 rhabditoid 유충 또는 기생세대 자충이 검출된 분선충 감염증 9례를 보고하고자 한다. 환자들은 50대와 70대 사이의 남자 7명 및 여자 2명으로 퇴행성 관절염으로 스테로이드계 약물을 장기 복용하였거나 소화기 장애, 고혈압, 간질환 정신장애 등 다양한 질환을 동반하고 있었다. 관절염, 소화기 장애 등으로 입원한 57세 여자 환자 1례에서는 albendazole 및 mebendazole 투여 4-5일 째의 설사변에서 분선충의 기생세대 자충 (parasitic females) 220마리가 회수되었다. 이 환자는 관절염에 대한 스테로이드 장기 복용으로 면역기능이 저하된 상태에서 자가감염된 중감염(hyperinfection) 예로서 우리 나라에서 기생세대 자충이 확인된 세 번째 증례이기도 하다.

• Parasites, Hosts and Diseases
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• 제46권4호
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• pp.261-263
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• 2008

Strongyloides stercoralis is a human intestinal parasite which may lead to complicated strongyloidiasis in immunocompromised. Here, a case of complicated strongyloidiasis in a patient with chronic lymphocytic leukemia is reported. Presence of numerous S. stercoralis larvae in feces and sputum confirmed the diagnosis of hyperinfection syndrome in this patient. Following recovery of filariform larvae from agar plate culture of the stool, the isolate was characterized for the ITS1 region of ribosomal DNA gene by nested-PCR and sequencing. Albendazole therapy did not have cure effects; and just at the beginning of taking ivermectin, the patient died. The most important clue to prevent such fatal consequences is early diagnosis and proper treatment.

• Parasites, Hosts and Diseases
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• 제60권3호
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• pp.181-185
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• 2022

Strongyloides stercoralis infection is not endemic in the Republic of Korea (Korea) with a positivity rate of <1% in stool examination. However, there is a risk of hyperinfection in immunosuppressed individuals. It is necessary to determine the seropositivity of S. stercoralis antibodies in Korea. This study investigated the seropositivity of S. stercoralis antibodies in the southeastern area of Korea. From January 2019 to June 2021, serum samples were collected from participants who visited the study center in the southeastern region of Korea for routine health check-ups. We determined serum levels of specific anti-Strongyloides IgG antibodies in 834 samples by enzyme-linked immunosorbent assay. We observed that 92 samples (11.0%) tested showed a positive response. The age of the participants was 51±10.7 years, and 43.4% of them were men. The antibody positivity rate based on the location of the participants' residence were 12.3% (Gyoungsangnam-do), 10.2% (Busan), and 10.1% (Ulsan), respectively. Total eosinophil count was associated with positive test results (154.8±152.0 per mm³ versus 202.1±178.9 per mm³, P=0.006). Logistic regression analysis revealed that blood eosinophil count, age above 50 years, and residence in Sacheon were factors associated with the positive status of S. stercoralis antibody. Our finding suggests that it is necessary to test for S. stercoralis in actual clinical settings in Korea.