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Disseminated strongyloidiasis presenting as purpura
S G Ronan1, R L Reddy, J R Manaligod
1Department of Pathology, University of Illinois College of Medicine, Chicago 60612.
Journal of the American Academy of Dermatology
|November 1, 1989
Summary
Disseminated strongyloidiasis, a severe parasitic infection, occurred in a patient treated with steroids for brain metastases. Despite thiabendazole, the patient succumbed to the infection, highlighting steroid-induced immunosuppression risks.
Area of Science:
- Parasitology
- Oncology
- Immunology
Background:
- Steroids are commonly used to manage cerebral edema in cancer patients.
- Immunosuppression from steroids can predispose individuals to opportunistic infections.
- Urinary bladder carcinoma with brain metastases presents a complex clinical scenario.
Observation:
- A patient with brain metastases developed extensive purpura.
- Skin biopsy revealed numerous Strongyloides stercoralis larvae.
- Rhabdoid larvae of S. stercoralis were found in stool and sputum.
Findings:
- The patient presented with disseminated strongyloidiasis.
- Steroid treatment for cerebral edema likely contributed to the parasitic dissemination.
- The infection was widespread, affecting skin, stool, and sputum.
Implications:
- This case underscores the risk of disseminated strongyloidiasis in immunocompromised patients.
- Steroid therapy in cancer patients requires careful monitoring for parasitic infections.
- Early diagnosis and treatment are crucial for managing strongyloidiasis, though outcomes can be poor in severe cases.