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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty children aged 5 to 12 years whose fecal examination confirmed of strongyloidiasis were divided into 2 groups. One group (Group I) of 26 received 400 mg albendazole once a day for 3 consecutive days. The other group (Group II) of 24 received the same dosage but repeated a week later. Simple smear fecal examination was performed for 3 consecutive days before treatment, and stool cultures were performed on Days 13, 14, 15 21, 22 and 23 after treatment. Evaluation of successful treatment or cure was based on the absence of larvae in 6 culture specimens. The cure rates were 80.8% in Group I and 91.7% in Group II (p = 0.18). Side effect consisted of mild and transient vomiting in one patient in each group. Although the difference in cure rates between the two drug regimens was not statistically different, two courses of treatment (Group II) resulted in a higher cure rate.
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PMID:Repeated doses of albendazole against strongyloidiasis in Thai children. 260 12

Infection with Strongyloides stercoralis, the most common intestinal parasite at our hospital, was encountered in 56 patients over a 3-yr period. The majority of the patients were male adults over 50 years old who had a chronic debilitating associated illness; about half the patients were immunocompromised. Strongyloidiasis was usually a chronic relapsing illness of mild to moderate severity characterized by gastrointestinal complaints (diarrhea, pain, tenderness, nausea, vomiting) and peripheral eosinophilia. Hypoalbuminemia also occurred. Stool examination for larvae was an effective method of diagnosing the parasite, and treatment with thiabendazole was usually successful. The frequent occurrence of S. stercoralis in geriatric patients with other medical problems and the delays in making the diagnosis suggest that the clinical spectrum of strongyloidiasis is greater than generally appreciated by the medical profession. Increased awareness of S. stercoralis is important to prevent the hyperinfection syndrome, which was estimated to occur in 1.5-2.5% of our patients.
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PMID:Clinical features of Strongyloides stercoralis infection in an endemic area of the United States. 722 72

We describe the features of intestinal strongyloidiasis in six patients; five of them were immunosuppressed (four on corticosteroids, one with chronic renal failure). Vomiting and diarrhea were the predominant symptoms. Duodenal mucosa on endoscopy varied from normal to severe ulceration. Albendazole 400 mg/day for two weeks was effective. This condition should be considered in immunosuppressed individuals with gastrointestinal symptoms, especially since these symptoms may be mistakenly attributed to the underlying disease.
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PMID:Intestinal strongyloidiasis--a rare opportunistic infection. 924 83

Two cases of fatal strongyloidiasis associated with diabetes mellitus and malnutrition are reported. The patients presented with repeated vomiting and upper gastrointestinal bleeding respectively. Unusual findings in these two patients included: unexplained peripheral leukocytosis, pulmonary infiltrates, gastric aspirate leukocytosis, progression of gastrointestinal symptoms and concurrent presence of adult worms, eggs, filariform and rhabditiform larvae of Strongyloides stercoralis in alimentary canal specimens. Both patients succumbed while receiving treatment with mebendazole. The present report illustrates that unexplained gastrointestinal symptoms with extensive scratch marks below the umbilicus can be important clues to early diagnosis of the disease. In addition, the various presentations of S. stercoralis infestation are discussed with reference to predisposing factors. Current trends in laboratory diagnosis and therapeutic considerations are also delineated.
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PMID:Two cases of fatal strongyloidiasis in Hong Kong. 927 Oct 28

A case of fatal strongyloidiasis associated with human T-cell lymphotropic virus type 1 (HTLV-1) infection is described in a 45-year-old West Indian man living in an area endemic for both strongyloidiasis and HTLV-1 infection. Clinical presentation was typical with severe diarrhea, vomiting, and progressive weight loss. Stool microscopy revealed Strongyloides stercoralis rhabditiform larvae. Despite treatment with thiabendazole, the patient died. Autopsy findings revealed severe ileocolitis due to Strongyloides larvae, right subdiaphragmatic pyogenic abscess, and severe pleuritis of the right lower lobe of the lung. This case illustrates that despite effective antihelmintic therapy, mortality is still high in patients with the hyperinfective state of S. stercoralis. Thus, in patients in areas endemic for both Strongyloides infection and HTLV-1, or in immigrants from these areas, repeated stool microscopy is indicated in patients positive for HTLV-1.
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PMID:Case study: Fatal strongyloidiasis associated with human T-cell lymphotropic virus type 1 infection. 1171 31

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

We report an immunodeficient patient with a rare gastrointestinal manifestation. A 26-year-old male with common variable immunodeficiency (CVID) and bronchiolitis obliterans, who was on intravenous gamma-globulin and prednisone, presented diffuse abdominal pain, nausea, vomiting and constipation of 3 days' duration. He reported 5 years of recurrent respiratory infections and diarrhea with negative stool tests, including tests for Strongyloides stercoralis. A physical exam revealed a poor general condition, anemia, dehydration and a distended painful abdomen with guarding, without abdominal sounds. The radiological study showed marked dilation of the small bowel that was edematous. Resection of the affected loop was performed and the histopathologic study showed transmural infection with S. stercoralis and hemorrhagic necrosis of the muscular layer, without mucosal destruction. The patient developed malabsorption syndrome and septic shock; he was treated with antibiotics and thiabendazole and was finally discharged in a good general condition. CVID is a rare disease and its association with systemic strongyloidiasis is very uncommon, but it has been reported in patients on corticosteroids. Hemorrhagic necrosis of the muscular layer without mucosal destruction was not found in the literature studied.
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PMID:A rare intestinal manifestation in a patient with common variable immunodeficiency and strongyloidiasis. 1668 1

Mesenteric lymph node involvement in Strongyloides stercoralis hyperinfective states, described as an autopsy finding, remains a relatively poorly recognized and possibly underreported, antemortem phenomenon. Furthermore, the occurrence of S stercoralis mesenteric lymphadenopathy as a tocsin of bowel strongyloidiasis and the clue to the cause of intestinal pseudo-obstruction are undescribed. We report S stercoralis mesenteric lymphadenopathy and intestinal pseudo-obstruction in 5 HIV seropositive male patients, 21 to 42 years, who presented with abdominal pain and variable vomiting, diarrhea, and constipation. All were pale, pyrexial, and emaciated with abdominal distension. The preoperative diagnosis was intestinal obstruction. Poor clinical response on conservative therapy necessitated laparotomy. Dilated small bowel loops, ascites, and mesenteric lymphadenopathy were consistently noted; a diagnosis of pseudo-obstruction due to underlying tuberculosis or lymphoma was made. The mesenteric lymph nodes were biopsied. The pertinent nodal features were a dense infiltrate of eosinophils, eosinophil microabscesses and degranulation, a focal Splendore-Hoeppli phenomenon, and randomly disposed, but elusive, S stercoralis filariform larvae. Clinical deterioration confirmed intestinal complications at repeat laparotomy. Intestinal resections were performed in 4 patients; histopathologic appraisal confirmed intestinal strongyloidiasis. All patients died within 3 to 7 days after surgery. Heightened awareness of S stercoralis mesenteric lymphadenopathy as a sentinel of intestinal strongyloidiasis and etiopathogenetic clue of intestinal pseudo-obstruction may allow timely diagnosis and medical treatment and avoidance of further surgery, potentially reducing the long-term morbidity associated with S stercoralis hyperinfection.
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PMID:Strongyloides stercoralis mesenteric lymphadenopathy: clue to the etiopathogenesis of intestinal pseudo-obstruction in HIV-infected patients. 1684 62

We report a fatal case of disseminated strongyloidiasis in a patient with multiple myeloma receiving chemrotherapy. A fifty-seven years old man presented with severe diarrhoea and vomiting, fever, weight loss and dysphagia,due to mouth ulcers. Despite broad-spectrum intravenous antibiotics, albendazole (anti protozoal) and supportive treatment, the patient died of Gram-negative sepsis.
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PMID:A fatal case of gram negative bacterial sepsis associated with disseminated strongyloidiasis in an immunocompromised patient. 1833 31

Strongyloides stercoralis, a nematode parasite, is endemic in tropical and subtropical regions. Infection usually remains asymptomatic, but in immunocompromised hosts hyperinfection and dissemination can occur, which has a high mortality. Early detection of S. stercoralis may alter the fatal course of infection. We present our experience of five patients with S. stercoralis hyperinfection diagnosed by endoscopic duodenal and jejunal biopsy in northern India. A predisposing factor was present in all patients in the form of corticosteroid intake, chronic liver disease and panhypogammaglobulinaemia. Common gastrointestinal symptoms were abdominal pain, diarrhoea, gastrointestinal bleeding, nausea, vomiting and weight loss with evidence of malabsorption. The initial stool examination and peripheral blood eosinophil count were normal in all patients. Strongyloidiasis was not suspected clinically in any patient and the diagnosis was achieved on endoscopic biopsy. Three of the patients with disseminated disease developed fatal Gram-negative systemic infection. This study highlights the importance of considering strongyloidiasis in all patients on immunosuppressive drug therapy who present with gastrointestinal symptoms so that the patient can be appropriately investigated and promptly treated. In endemic regions, patients with systemic Gram-negative bacterial infections without an obvious cause should be tested for strongyloidiasis.
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PMID:Intestinal strongyloidiasis: a diagnosis frequently missed in the tropics. 1880 29


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