Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 58-year-old male from Puerto Rico who was taking orally administered cortisone analogs for chronic obstructive pulmonary disease presented with fever, absolute eosinophilia, right lower quadrant pain, and rebound tenderness associated with Strongyloides stercoralis infection of the appendix. A 37-year-old alcoholic male developed fever, right lower quadrant abdominal pain, and rebound tenderness because of infection of the appendix with Entamoeba histolytica. These are the seventh reported case of isolated amebic appendicitis and the ninth reported case of appendiceal involvement with Strongyloides. In all these cases the diagnosis was made only after surgery. Patients with unexplained right lower quadrant pain, particularly if immunosuppressed or with an appropriate travel history, should have stool examinations for ova and parasites. Early diagnosis and treatment may prevent life-threatening complications such as perforation and peritonitis.
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PMID:Appendiceal infection by Entamoeba histolytica and Strongyloides stercoralis presenting like acute appendicitis. 218 2

A case with severe diarrhoea and Strongyloides stercoralis infection is described. Further examination showed that the patient also had abnormal colonization of the duodenum with Hafnia alvei and that this disappeared when the Strongyloides infection was treated with mebendazole. Symptoms such as abdominal pain, diarrhoea, "skin rash" and malabsorption in association with blood eosinophilia should arouse suspicion of strongyloidiasis.
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PMID:A case with severe diarrhoea and Strongyloides stercoralis infection. 723 12

The diagnosis and management of strongyloidiasis present a continuous challenge in developing countries including Taiwan. In this study, the clinical characteristics and microbiological findings of 27 patients with Strongyloides stercoralis infection were retrospectively analyzed. Intestinal infection was identified in 17 patients and hyperinfection syndrome or disseminated disease in 10 (including 2 autopsy cases). The most frequent clinical findings were diarrhea (74%), fever (70%), abdominal pain (59%), cough (37%), dyspnea (33%), and constipation (26%). The common initial laboratory abnormalities were leukocytosis (81%), anemia (67%), liver function impairment (52%), and eosinophilia (44%). Most of the 27 patients had comorbid conditions, including malnutrition in 20 (74%), corticosteroid dependence in 15 (55%), chronic obstructive pulmonary disease in 9 (33%), chronic liver disease or cirrhosis in 8 (30%), and peptic ulcer disease in 7 (26%). There was no difference in the time interval from symptom onset to diagnosis between the intestinal infection group and the hyperinfection/disseminated group (22 +/- 15 vs 17 +/- 9 days). Larvae of S. stercoralis were identified in the stool of 24 patients, in the sputum smear of 5, in the gastric biopsy of one, and on histology of autopsy specimens in 2. Twenty-six patients received antiparasitic drug therapy of variable duration (mebendazole in 24, albendazole in 2, combined therapy in one). The overall cure rate was 52% (14/27). Relapse occurred in 4 patients. The overall mortality was 26% (7/27). There was a high mortality (up to 50%) in the hyperinfection/disseminated disease group. In conclusion, diagnosis of strongyloidiasis is often delayed and overlooked because of nonspecific symptoms. Physicians in endemic regions should include strongyloidiasis in the differential diagnosis when patients present with gastrointestinal and/or pulmonary symptoms with peripheral eosinophilia.
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PMID:Clinical manifestations of strongyloidiasis in southern Taiwan. 1195 Jan 17

A case of Strongyloides stercoralis infection wss 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 degrees 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 mebendazole. After the administration of thiabendazole, however, diarrhoea was stopped. On the 6th day of medication, S. stercoralis larvae were 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. Therefore 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.
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PMID:[A case of hyperinfection syndrome with Strongyloides stercoralis] 1288 66

In order to determine the epidemiological factors and clinical symptoms associated with Strongyloides stercoralis infection, we carried out a descriptive study with a control group in the District of Chanchamayo, Province of Chanchamayo, Junin, Peru. Group I (n = 50) represented those individuals with strongyloidosis and group II (n = 50) were those who tested negative for S. stercoralis by parasitological methods. Epidemiological variables significantly associated with group I were: bathing in the river 3-4 times per week, consuming non-drinking water, defecating in the field; and with group II: drinking boiled water, wearing sneakers and living in houses with cement floor. The clinical symptoms of epigastric pain, daily abdominal pain, semi liquid feces, liquid feces, daily defecation frequency, urticaria and nausea were significantly associated with group 1; whereas more solid feces and defecating every other day were significantly associated with group II. Among individuals under the age of 20 there was a higher percentage of malnutrition according to the weight-age index in group I (p = 0.045). We conclude that infection by S. stercoralis should be suspected in persons from tropical areas who are in frequent contact with rivers or streams or live close to watercourses, who have gastroenterological or dermatological symptoms or who are malnourished, especially if they are children or adolescents.
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PMID:[Factors associated with strongyloides stercoralis infection in an endemic area in Peru]. 1721 85

Strongyloidiosis is widely distributed in tropical and subtropical areas but is a rarely reported parasitic infestation in Turkey. Disseminated strongyloidiosis may develop in patients with immunodeficiencies. We report a case of Strongyloides stercoralis infection and Loeffler's syndrome that developed in a patient who had received systemic prednisolone. The patient was a 20 year-old man, born in Hatay, Turkey. The patient presented at our department complaining of abdominal pain and leg pain. After he was admitted for further examination; headache, sore throat and cough developed. The differential-leukocytic count was characterized by 14% eosinophils. When a stool examination was performed, Strongyloides stercoralis larvae were observed. The patient was treated successfully with albendazole. His symptoms improved and Strongyloides stercoralis was not detected in subsequent follow-up examinations thereafter.
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PMID:[Strongyloidiosis and Loeffler's syndrome detected in a patient who used a short term steroid treatment]. 1835 51

Strongyloides stercoralis infection is a common cause of abdominal pain and diarrhea worldwide. Usually a chronic and limited disease, it can present a therapeutic dilemma when infection is overwhelming, such as what might occur in an immunosuppressed patient. Here we present a case of strongyloides hyperinfection treated successfully with a veterinary formulation of parenteral ivermectin.
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PMID:Strongyloides hyperinfection: a treatment dilemma. 1885 83

A 40-year-old woman from El Salvador presented with 3 months of abdominal pain and diarrhea followed by 2 weeks of atypical chest pain and exertional dyspnea and was diagnosed with eosinophilic endocarditis secondary to Strongyloides stercoralis infection. Transthoracic echocardiogram revealed apical masses in the left and right ventricles and a thickened posterior mitral valve leaflet and cardiac magnetic resonance imaging confirmed the presence of a left ventricular apical mass with diffuse subendocardial delayed enhancement consistent with endocardial fibrosis. In conclusion, eosinophilic endocarditis is a rare cause of restrictive cardiomyopathy characterized by endomyocardial fibrosis and apical thrombosis and fibrosis with frequent involvement of the posterior mitral valve leaflet.
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PMID:Eosinophilic endocarditis and Strongyloides stercoralis. 2367 85

The presence of Strongyloides stercoralis infection in patients with systemic lupus erythematosus (SLE) has been described previously. Strongyloides stercoralis hyperinfection syndrome (SHS) that usually develops in patients under immunosuppressive therapy may affect a variety of organs, but the presentation with diffuse alveolar hemorrhage (DAH) is rare with only a few cases described in the literature. We present the case of a 36-year-old Hispanic female with a past medical history relevant for SLE and a recent diagnosis of lupus nephritis and hypertension. The patient who developed sudden and progressive abdominal pain and respiratory distress, with the presence of bilateral crackles and severe hypoxemia, is currently under treatment with steroids and cyclophosphamide for worsening of lupus nephritis. The patient underwent endotracheal intubation and mechanical ventilation, and computed tomography showed the presence of bilateral pulmonary infiltrates suggestive of DAH. Bronchoalveolar lavage was done and showed the presence of filariform larvae, morphologically consistent with Strongyloides stercoralis. Treatment with ivermectin was started and patient responded to treatment with improvement of clinical status. In conclusion, the development of SHS in patients with lupus, especially when receiving immunosuppressive therapy, is a severe and potentially fatal complication. Early detection and treatment may decrease mortality.
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PMID:Strongyloidiasis and diffuse alveolar hemorrhage in a patient with systemic lupus erythematosus. 2502 6

Infection by Strongyloides stercoralis is a highly prevalent helminthiasis, which is mostly distributed in the tropical and subtropical regions of the world. Although a substantial number of cases are asymptomatic or paucisymtomatic, severe and life-threatening forms of this infection still occur and not infrequently is lately diagnosed. Gram-negative bacteria septicemia, which frequently accompanies the severe helminthiasis, contributes to the high mortality rate. Severe infection is invariably triggered by any imbalance in the host's immunity, favoring the auto-infective cycle, which increases the intraluminal parasite burden enormously. Clinical presentation of severe cases is varied, and diagnosis requires a high suspicion index. Acute abdomen has been reported in association with S. stercoralis infection, but intestinal necrosis is rarely found during the surgical approach. The authors report the case of a man who sought the emergency unit with recent onset abdominal pain. Clinical and imaging features were consistent with obstructive acute abdomen. Scattered adhesions and a necrotic ileal segment with a tiny perforation represented the surgical findings. The patient outcome was unfavorable and respiratory distress required an open lung biopsy. Both surgical specimens showed S. stercoralis infection. Unfortunately the patient underwent multiple organ failure and septicemia, and subsequently died. The authors call attention to the finding of intestinal necrosis and impaired intestinal motility disorder as possibilities for the diagnosis and risk factor, respectively, for a severe infection of S. stercoralis.
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PMID:Strongyloides stercoralis hyperinfection associated with impaired intestinal motility disorder. 2648 31


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