ABSTRACT
PURPOSE: We report a fatal case of Strongyloides hyper-infection as the result of corticosteroid therapy of a patient with myasthenia gravis. CASE PRESENTATION: Our patient was a farmer with a past history of living in an endemic area for Strongyloides stercoralis in Iran. Hyper-infection was diagnosed during the advanced-stage disease by demonstration of enormous number of larvae in the direct smears prepared from both the stool and tracheal secretions. Unfortunately, despite appropriate anti-parasite therapy, the patient died due to respiratory failure. CONCLUSION: We recommend the provision of more awareness in high-risk people prior to immunosuppressive therapy, through screening for S. stercoralis, even in non-endemic regions.
Subject(s)
Myasthenia Gravis/parasitology , Strongyloidiasis/diagnosis , Albendazole/administration & dosage , Antinematodal Agents/administration & dosage , Endemic Diseases , Fatal Outcome , Humans , Immunocompromised Host , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Iran/epidemiology , Ivermectin/administration & dosage , Male , Middle Aged , Myasthenia Gravis/drug therapy , Myasthenia Gravis/immunology , Prednisolone/administration & dosage , Prednisolone/adverse effects , Strongyloidiasis/drug therapy , Strongyloidiasis/epidemiology , Strongyloidiasis/immunologyABSTRACT
Multi-drug therapy (MDT) and Leprosy Elimination Campaigns (LEC) are the major strategies for eliminating leprosy. We report the results of a LEC conducted in 2006 in Qazvin. A total of 1987 individuals (1379 household contacts of 319 registered leprosy patients and 608 people from 3 endemic villages with a high prevalence of leprosy) were examined for detection of new cases of leprosy. All new cases were given MDT and were reviewed after a year. There were 256 suspected cases of leprosy, 13 of whom were confirmed as new cases (7 were classified as multibacillary leprosy). None had visible deformity nor was < 20 years old. All patients completed the recommended MDT course. The few cases detected suggest that in low prevalence areas, a long-term approach of integrated leprosy services and disability management may be more appropriate than LEC as a leprosy elimination strategy.
Subject(s)
Communicable Disease Control/methods , Endemic Diseases/prevention & control , Leprosy/prevention & control , Outcome Assessment, Health Care , Adult , Communicable Disease Control/organization & administration , Drug Therapy, Combination , Humans , Iran/epidemiology , Leprostatic Agents/administration & dosage , Leprosy/drug therapy , Leprosy/epidemiology , Leprosy, Multibacillary , Mass Screening , Middle AgedABSTRACT
Multi-drug therapy [MDT] and Leprosy Elimination Campaigns [LEC] are the major strategies for eliminating leprosy. We report the results of a LEC conducted in 2006 in Qazvin. A total of 1987 individuals [1379 household contacts of 319 registered leprosy patients and 608 people from 3 endemic villages with a high prevalence of leprosy] were examined for detection of new cases of leprosy. All new cases were given MDT and were reviewed after a year. There were 256 suspected cases of leprosy, 13 of whom were confirmed as new cases [7 were classified as multibacillary leprosy]. None had visible deformity nor was < 20 years old. All patients completed the recommended MDT course. The few cases detected suggest that in low prevalence areas, a long-term approach of integrated leprosy services and disability management may be more appropriate than LEC as a leprosy elimination strategy
