RESUMO
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.
Assuntos
Miastenia Gravis/parasitologia , Estrongiloidíase/diagnóstico , Albendazol/administração & dosagem , Antinematódeos/administração & dosagem , Doenças Endêmicas , Evolução Fatal , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Irã (Geográfico)/epidemiologia , Ivermectina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/tratamento farmacológico , Miastenia Gravis/imunologia , Prednisolona/administração & dosagem , Prednisolona/efeitos adversos , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/epidemiologia , Estrongiloidíase/imunologiaRESUMO
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.
Assuntos
Controle de Doenças Transmissíveis/métodos , Doenças Endêmicas/prevenção & controle , Hanseníase/prevenção & controle , Avaliação de Resultados em Cuidados de Saúde , Adulto , Controle de Doenças Transmissíveis/organização & administração , Quimioterapia Combinada , Humanos , Irã (Geográfico)/epidemiologia , Hansenostáticos/administração & dosagem , Hanseníase/tratamento farmacológico , Hanseníase/epidemiologia , Hanseníase Multibacilar , Programas de Rastreamento , Pessoa de Meia-IdadeRESUMO
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
