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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With few exceptions, the parasitic pneumonias most commonly encountered in the Western Hemisphere are diseases of compromised hosts; patients with AIDS are at particular risk. Pneumocystis carinii pneumonia occurs eventually in 80% of AIDS patients; bronchoalveolar lavage is quite sensitive in establishing this diagnosis. Toxoplasma gondii pneumonia, seen most often in the patient with AIDS, is characterized by multisystem involvement. Strongyloides stercoralis infection is endemic in the Southeastern United States. Pulmonary strongyloidiasis is seen in patients receiving glucocorticoids or chemotherapy, and in patients with AIDS or other causes of T cell dysfunction. Larvae may be seen on Gram's stains or wet mounts of sputum. Ascaris and hookworm infections may present with pulmonary infiltrates and eosinophilia during the larval migration phase. Dirofilaria, Paragonimus, and Entamoeba histolytica involvement of the lung are less common and require a good epidemiologic history and clinical suspicion for diagnosis.
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PMID:Parasitic pneumonia. 304 17

The case of a 64-year-old man who was admitted to hospital with fever, general deterioration and anorexia is reported. For the past 4 years, the patient had been receiving corticosteroid therapy for a chronic inflammatory demyelinating polyradiculoneuropathy. Soon after admission the patient developed respiratory insufficiency as a result of a massive pneumonitis, with severe hypoxia, acute anaemia, acute renal failure and a systemic inflammatory response syndrome (SIRS) requiring admission to the Intensive Care Unit (ICU). All faecal, bronchial, duodenal and urine samples showed Strongyloides stercoralis larvae. Despite antihelmintic therapy and cardiorespiratory support, the patient died from the consequences of irreversible shock. Strongyloidiasis is present worldwide and can be a chronic, essentially asymptomatic infection. This nematode can produce an overwhelming hyperinfection syndrome, especially in patients showing deficient cell-mediated immunity. Strongyloides hyperinfection syndrome is frequently fatal but is potentially a treatable clinical condition. Patients undergoing immunosuppressive therapy or with suspected immunity deficiency (HIV infection, malnutrition, lymphomas, leukaemias or other neoplasia treated with systemic radiotherapy or chemotherapy) must be also monitored for opportunistic Strongyloides stercoralis infection, because clinical manifestation of the systemic hyperinfection syndrome can be rather non-specific.
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PMID:Hyperacute pneumonitis in a patient with overwhelming Strongyloides stercoralis infection. 888 26

Patients with AIDS are prone to develop infections caused by opportunistic pathogens. Unusual agents, such as Strongyloides stercoralis, are being described in this syndrome, resulting in disseminated disease which is always severe and, in some cases, fatal. We describe a case of a patient with AIDS and Strongyloides stercoralis infection involving the gastrointestinal tract and the lungs. Therapy with thiabendazole for ten days led to resolution of the acute episode. Preventive therapy with 3g of thiabendazole once a week was then prescribed, and repeated fecal examinations were negative for larvae. Following discontinuation of treatment, however, the patient again had a positive fecal examination for Strongyloides stercoralis larvae, even though reinfection was considered to be very unlikely. The patient was retreated with a shorter course of therapy and once per week preventive therapy was reintroduced. After four months of follow-up, repeated fecal examinations were negative. When the treatment was changed to thiabendazole given once every two weeks, however, pulmonary Strongyloides stercoralis recurred. Subsequently, because of intolerance to thiabendazole, the patient was treated with cambendazole. The patient died three months later due to Pseudomonas aeruginosa pneumonia. Prolonged therapy for Strongyloides stercoralis infection may be necessary. Although further evaluation is needed, 3g of thiabendazole once a week may be adequate for this purpose. Cambendazole may be a useful alternative for disseminated Strongyloides stercoralis.
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PMID:Disseminated Strongyloides stercoralis Infection in an AIDS Patient: The Role of Suppressive Therapy. 1110 39