PMID- 20738204
OWN - NLM
STAT- MEDLINE
DCOM- 20100914
LR  - 20220410
IS  - 1937-2345 (Electronic)
IS  - 0022-3395 (Linking)
VI  - 96
IP  - 4
DP  - 2010 Aug
TI  - Asymptomatic Strongyloides stercoralis hyperinfection in an alcoholic patient 
      with intense anemia.
PG  - 833-5
LID - 10.1645/GE-2358.1 [doi]
AB  - Strongyloides stercoralis infection is endemic in many tropical and subtropical 
      areas. The parasite has the unusual ability to multiply inside the host due to 
      the transformation of rhabditiform larvae into infective filariforms. Several 
      studies have shown that chronic alcoholism is an important factor that 
      predisposes to strongyloidiasis. The increased susceptibility to S. stercoralis 
      infections seen in alcoholic individuals could be explained by their increased 
      exposure to the parasite, malnutrition, breakdown of local immune responses, 
      and/or alterations in intestinal barriers. Moreover, ethanol intoxication can 
      elevate human endogenous corticosterone, which, in turn, suppresses T cell 
      function and increases the fecundity and survival of the parasite, mimicking the 
      effect of worm ecdysteroides. Although chronic alcoholism is a risk factor for 
      nematode infection, most cases of hyperinfection or dissemination are associated 
      with the presence of hepatic cirrhosis or strongyloidiasis-related symptoms. The 
      present study describes a case of S. stercoralis hyperinfection in a 51-yr-old 
      male patient without gastrointestinal or pulmonary symptoms and with previous 
      anemia and chronic alcoholism. He was not receiving glucocorticoid therapy and 
      tested negative for HTLV and human immunodeficiency virus (HIV), but he had a 
      history of alcohol addiction for more than 20 yr. Laboratory test results showed 
      increased eosinophilia and a high immunoglobulin E (IgE) level, which may have 
      temporarily protected the patient from dissemination of infection, but not 
      prevented proliferation of the parasite, as shown by the large number of S. 
      stercoralis larvae recovered using the Baermann method. Evaluation for 
      strongyloidiasis should occur in alcoholics, especially in endemic areas, to 
      prevent occult asymptomatic infections from progressing to life-threatening 
      cases.
FAU - Teixeira, M C A
AU  - Teixeira MC
AD  - Departmento de Analises Clinicas e Toxicologicas, Universidade Federal da Bahia, 
      Bahia, Brazil 40170-115.
FAU - Ines, E J
AU  - Ines EJ
FAU - Pacheco, F T F
AU  - Pacheco FT
FAU - Silva, R K N R
AU  - Silva RK
FAU - Mendes, A V
AU  - Mendes AV
FAU - Adorno, E V
AU  - Adorno EV
FAU - Lima, F M
AU  - Lima FM
FAU - Soares, N M
AU  - Soares NM
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Parasitol
JT  - The Journal of parasitology
JID - 7803124
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Alcoholism/*complications/immunology
MH  - Anemia/*complications/etiology
MH  - Animals
MH  - Eosinophilia/etiology
MH  - Feces/parasitology
MH  - Humans
MH  - Immunoglobulin E/blood
MH  - Male
MH  - Middle Aged
MH  - Occult Blood
MH  - Strongyloides stercoralis/*isolation & purification
MH  - Strongyloidiasis/*complications/diagnosis
EDAT- 2010/08/27 06:00
MHDA- 2010/09/16 06:00
CRDT- 2010/08/27 06:00
PHST- 2010/08/27 06:00 [entrez]
PHST- 2010/08/27 06:00 [pubmed]
PHST- 2010/09/16 06:00 [medline]
AID - 10.1645/GE-2358.1 [doi]
PST - ppublish
SO  - J Parasitol. 2010 Aug;96(4):833-5. doi: 10.1645/GE-2358.1.