ABSTRACT
Strongyloides stercoralis is a soil transmitted intestinal nematode that is endemic in the tropical and subtropical regions. In most individuals who are infected, chronic, usually asymptomatic, gastrointestinal infection persists. But, in immunocompromized hosts or in patients receiving immunosuppressive therapy, autoinfection of S. stercoralis may result in the dissemination of larvae, leading to fatal hyperinfection and increased rate of complications. We report a case of hyperinfective strongyloidiasis with bacterial meningitis in a patient receiving steroid therapy. Strongyloidiasis was diagnosed by the presence of filariform larvae of S. stercoralis in the bronchoalveolar lavage cytology and upper gastrointestinal endoscopic biopsy specimen. Her clinical symptoms had progressively aggravated and developed bacterial meningitis during treatment. She died despite aggressive antibiotic and antihelminthic therapy.
Subject(s)
Aged , Animals , Female , Humans , Adrenal Insufficiency/drug therapy , Bronchoalveolar Lavage Fluid/parasitology , Endoscopy, Gastrointestinal , Enterococcus faecium/isolation & purification , Immunocompromised Host , Intestinal Mucosa/pathology , Larva/physiology , Magnetic Resonance Imaging , Meningitis, Bacterial/complications , Steroids/adverse effects , Strongyloides stercoralis/growth & development , Strongyloidiasis/complicationsABSTRACT
Wilms' tumor is the most common malignant abdominal tumor in the adolescent and pediatric period, whereas adult Wilms' tumor is uncommon. Wilms' tumor often originates in the kidney. Extrarenal Wilms' tumor is rare and has been considered "unstageable". Therefore, treatment and long-term survival have not been uniformly reported. We report a 24 year-old female who developed extrarenal Wilms' tumor, in the retroperitoneal space. She was misdiagnosed for ovarian neoplasm and underwent debulking operation, by which Wilms' tumor was confirmed. Palliative chemotherapy and radiotherapy were performed.