Did someone say Idiot Pathetic? That's my cue!
This is good news. This disease took my uncle. Thanks for the post.
Did someone say Idiot Pathetic? That's my cue!
Mukerjee CM, Carrick J, Walker JC, Woods RL.
Liverpool Hospital, Liverpool, Sydney, Australia.
Two patients presented with long-standing chronic bronchitis and exertional dyspnoea of 5 and 3 months' duration, respectively, and had interlobular septal fibrosis on chest high resolution CT. In the past both had lived in areas in which Strongyloides stercoralis was known to be endemic. Serological tests confirmed the diagnosis of pulmonary strongyloidiasis, and both patients were treated with anti-helminthic medications, including albendazole and ivermectin. Following this there was complete resolution of both symptomatic and radiological manifestations of their disease. An awareness of the possibility of Strongyloides infection presenting with respiratory symptoms in patients exposed to this parasite is important in the management of such patients.
PMID: 14708557 [PubMed - indexed for MEDLINE]
Mariotta S, Pallone G, Li Bianchi E, Gilardi G, Bisetti A.
Department of Cardiovascular and Respiratory Sciences, University La Sapienza, Rome, Italy.
The Strongyloides stercoralis infection is a prominent cause of death in many areas of the world. A 64-year-old man with pulmonary fibrosis was admitted to the hospital because of progressive shortness of breath and increasing cough. The patient had been previously admitted for his illness and had a remarkable immunosuppression due to the use of steroids (CD4+ lymphocytes = 200 x 10(6)/l). Repeated sputum and stool studies were diagnostic for strongyloidiasis. The patient died suddenly from severe cardiorespiratory failure while he was under mebendazole treatment (100 mg b.i.d.). Strongyloidiasis occurs mostly in immunocompromised hosts, as in patients with chronic pulmonary diseases on long-term treatment with corticosteroids, oncology patients under treatment and patients with AIDS.
PMID: 8766880 [PubMed - indexed for MEDLINE]
Lin AL, Kessimian N, Benditt JO.
Division of Pulmonary Medicine, Memorial Hospital of Rhode Island, Pawtucket.
Strongyloidiasis is caused by the nematode Strongyloides stercoralis. The parasite has a unique life cycle that enables it to cause a hyperinfection syndrome in which pulmonary involvement is characteristic. We describe the case of a 68-yr-old Hispanic male from Puerto Rico with disseminated strongyloidiasis who developed intense granulomatous reaction in the lung associated with interlobular septal fibrosis. Granulomatous lung disease leading to fibrosis within the lung has been well demonstrated in schistosomiasis, another parasitic disease. This case represents the first report, as far as we are aware, of fibrosis within the lung and restrictive pulmonary disease in association with Strongyloides stercoralis.
PMID: 7812554 [PubMed - indexed for MEDLINE]
[It can also cause fibrosis in the heart]:
Dept of Medicine, University of the Orange Free State, Bloemfontein, South Africa.
A 42 year old man presented with steroid resistant asthma of 6 months duration. Serial chest radiographs showed migrating interstitial shadowing. Electrocardiographs showed decreasing R-wave progression in the precordial leads, and endomyocardial biopsy showed eosinophil infiltration with fibrosis. Bronchoscopy revealed inflammatory changes and lavage showed filariform larvae of Strongyloides stercoralis in the washings. This confirms the diagnosis of parasitic infection with eosinophilic cardiomyopathy.
PMID: 7841976 [PubMed - indexed for MEDLINE]
A good friend died of coronary fibrosis. Probably not from strongyloidiasis.
And yet... And yet... The disease is often diagnosed at autopsy, or after steroid treatment has caused so much proliferation that it is too late to save the patient.
The VA seems to have an intentional, institutional blindness regarding this disease. It is endemic in the soil of (among other places) Vietnam.
I think (I BELIEVE) that, if this institutional blindness can be overcome, we will find that MANY of the anomalies and symptoms which are now blamed on PTSD (and Gulf War Syndrome) wil be found to (at least in part) be caused by Strongyloidiasis.
DG
p.s. In Strongyloidiasis, corticosteroids (Prednisone, Cortisone) KILL!