Strongyloides stercoralis hyperinfection syndrome in a patient with behçet's disease

Ayşe BOYVAT, Aynur AKYOL, Banu ÇAĞLAR, Gamze ALKIZ, Bengü Nisa AKAY, İnsu YILMAZ

Abstract

Strongyloides stercoralis is endemic in the tropical and subtropical areas of the world. It is a soil-transmitted intestinal nematode affecting anywhere from 30 to 100 million people worldwide. Strongyloides stercoralis is capable of causing autoinfection, which increases larval migration and proliferation in the host. This condition may lead to hyperinfection syndrome which has the potential to cause serious life- threatening complications, especially in immunosuppressed patients. Thus, Strongyloides stercoralis hyperinfection syndrome should be suspected if there are clinical clues including gastrointestinal tract symptoms (abdominal pain, nausea, vomiting, diarrhoea), respiratory tract symptoms (cough, dyspnoea, wheezing, haemoptysis), skin symptoms (pruritus, erythema) and peripheral eosinophilia in a patient with underlying risk factors. Herein, we report a case of Strongyloides stercoralis hyperinfection syndrome in a patient with Behçet’s Disease on immunosuppressive treatment.

Özet

Strongyloides stercoralis dünyada 30-100 milyon insanı etkileyen çoğunlukla tropikal ve subtropikal bölgelerde endemik olan, topraktan bulaşan intestinal bir nematoddur. Strongyloides stercoralis otoenfeksiyon ile artmış larval proliferasyon ve migrasyona neden olarak özellikle immün yetmezliği olan ya da immünsüpresif tedavi alan hastalarda yaşamı tehdit eden hiperenfeksiyon sendromu’na neden olabilmektedir. Bu nedenle risk grubundaki bu hastalarda; periferal eozinofili, solunum semptomları (öksürük, hırıltı, nefes darlığı, hemoptizi), gastrointestinal (GİS) semptomlar (abdominal ağrı, bulantı, kusma, diyare) ve cilt semptomları (kaşıntı, eritem) varsa gecikmiş tanıdaki mortalite yüksekliği nedeniyle mutlaka Strongyloides stercoralis hiperenfeksiyon sendromu akla getirilmelidir. Burada Behçet hasta