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
We report a case of severe malaria in a patient with underlying myasthenia gravis who was successfully treated with artesunate. The outcome was favorable. Artesunate seems to be a good option for patients with underlying myasthenia gravis disease because they benefit from a better toxicity profile than quinine.
