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Parasitol Int ; 61(3): 508-11, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22575692

RESUMO

INTRODUCTION: Strongyloides stercoralis infection can persist in the host for several decades, and patients with cancer and other clinical conditions who are exposed to immunosuppressive therapy are at risk of developing hyperinfection. CASE REPORT: This is a case of angioimmunoblastic T-cell lymphoma (AITL) in a patient with lymphadenopathy and bulky neck mass. Severe sepsis and episodes of diarrhea were observed upon the first cycle of cyclophosphamide, doxorubicin, oncovin (vincristine) and prednisone (CHOP) regime chemotherapy preceded by high dose of dexamethasone. There was Klebsiella pneumoniae bacteremia and moderate eosinophilia. Rhabditiform S. stercoralis larvae were observed in the stool, and this was confirmed by real-time PCR. Strongyloides-specific IgG and IgG4 were also positive. The patient was treated with oral albendazole (400mg/day) for 3 days and intravenous tazocin (4.5gm/6 hours) for 5 days; however he succumbed following multi-organ failure. CONCLUSION: This is likely a case of Strongyloides hyperinfection with secondary bacteremia.


Assuntos
Linfadenopatia Imunoblástica/patologia , Choque Séptico/patologia , Estrongiloidíase/patologia , Idoso , Animais , Ciclofosfamida/uso terapêutico , Diarreia/complicações , Diarreia/parasitologia , Diarreia/fisiopatologia , Doxorrubicina/uso terapêutico , Evolução Fatal , Humanos , Linfadenopatia Imunoblástica/complicações , Linfadenopatia Imunoblástica/tratamento farmacológico , Linfadenopatia Imunoblástica/parasitologia , Injeções Intravenosas , Malásia/epidemiologia , Masculino , Prednisona/uso terapêutico , Choque Séptico/complicações , Choque Séptico/tratamento farmacológico , Choque Séptico/parasitologia , Strongyloides stercoralis/crescimento & desenvolvimento , Strongyloides stercoralis/patogenicidade , Estrongiloidíase/complicações , Estrongiloidíase/tratamento farmacológico , Resultado do Tratamento , Vincristina/uso terapêutico
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