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      • Record: found
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      Pulmonary Strongyloidiasis Masquerading as Exacerbation of Chronic Obstructive Pulmonary Disease

      case-report

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          Abstract

          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.

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          Screening, prevention, and treatment for hyperinfection syndrome and disseminated infections caused by Strongyloides stercoralis.

          Thomas B Nutman, Rojelio Mejia (2012)
          This review discusses the latest approaches to the diagnosis and treatment of patients with strongyloidiasis, with an emphasis on infection in the immunocompromised host and the risk for disseminated strongyloidiasis. The differences in acute, chronic, accelerated autoinfection, and disseminated disease in Strongyloides stercoralis infection are explored with particular emphasis on early diagnosis, treatment, and prevention. The goals of treatment are investigated for the different infection states. Predisposing risks for dissemination are delineated, and the roles played for newer diagnostics in the identification of at-risk individuals are detailed. The use of newer diagnostic tests and broader screening of immunocompromised patients from Strongyloides-endemic areas is of paramount importance, particularly if prevention of life-threatening dissemination is the goal.
          Article 0 comments Cited 110 times – based on 0 reviews     Review now
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            Management and prevention of exacerbations of COPD.

            Shawn D Aaron (2014)
            Patients with chronic obstructive pulmonary disease (COPD) are prone to acute respiratory exacerbations, which can develop suddenly or subacutely over the course of several days. Exacerbations have a detrimental effect on patients' health status and increase the burden on the healthcare system. Initial treatment is unsuccessful in 24-27% of patients, who have a relapse or a second exacerbation within 30 days of the initial event. No obvious benefit has been seen in recent clinical trials of anti-tumour necrosis factor therapy, anti-leukotriene therapy, intensive chest physiotherapy, or early inpatient pulmonary rehabilitation for treatment of exacerbations. By contrast, clinical trials of prevention rather than acute treatment have shown promising results. Long acting β agonist (LABA) or long acting anti-muscarinic (LAMA) bronchodilators and inhaled corticosteroid-LABA combinations prevent exacerbations in patients at risk, with relative risk reductions averaging 14-27% for each of these drugs relative to placebo. Triple therapy with inhaled corticosteroid-LABA plus LAMA may provide additional benefit, although study results to date are heterogeneous and more studies are needed. Pneumonia is an important complication of treatment with inhaled corticosteroid-LABA products, and the risk of pneumonia seems to be doubled in patients with COPD who use fluticasone. The addition of azithromycin to usual COPD therapy prevents exacerbations, although it may prolong the Q-T interval and increase the risk of death from cardiovascular disease in patients prone to arrhythmia. New potential drugs--including mitogen activated protein kinase inhibitors, phosphodiesterase 3 inhibitors, and monoclonal antibodies to the interleukin 1 receptor--offer additional hope for treatments that may prevent exacerbations in the future.
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              Strongyloides stercoralis hyperinfection syndrome and disseminated disease.

              Klaus Mönkemüller, Marco Kassalik (2011)
              Article 0 comments Cited 25 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Tuberc Respir Dis (Seoul)
                Journal ID (iso-abbrev): Tuberc Respir Dis (Seoul)
                Journal ID (publisher-id): TRD
                Title: Tuberculosis and Respiratory Diseases
                Publisher: The Korean Academy of Tuberculosis and Respiratory Diseases
                ISSN (Print): 1738-3536
                ISSN (Electronic): 2005-6184
                Publication date (Print): October 2016
                Publication date (Electronic): 05 October 2016
                Volume: 79
                Issue: 4
                Pages: 307-311
                Affiliations
                [1 ]Department of Pulmonary Medicine, All India Institute of Medical Sciences, Bhubaneswar, India.
                [2 ]Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India.
                Author notes
                Address for correspondence: Manoj Kumar Panigrahi, M.D. Department of Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, Odisha, India. Phone: 91-9438884282, Fax: 91-6742476555, panigrahimanoj75@ 123456gmail.com
                Article
                DOI: 10.4046/trd.2016.79.4.307
                PMC ID: 5077736
                SO-VID: 4dd5868b-3a3a-48f6-ac51-25c8cd3b232a
                Copyright © Copyright©2016. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.
                License:

                It is identical to the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/)

                History
                Date received : 26 April 2015
                Date revision received : 01 July 2015
                Date accepted : 31 May 2016
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Respiratory medicine
                Keywords: strongyloides stercoralis,hyperinfection syndrome,adrenal cortex hormones,acute disease,pulmonary disease, chronic obstructive
                Data availability:
                ScienceOpen disciplines: Respiratory medicine
                Keywords: strongyloides stercoralis, hyperinfection syndrome, adrenal cortex hormones, acute disease, pulmonary disease, chronic obstructive

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