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A case of triple infection including strongyloides stercoralis in a microscopic polyangiitis patient

De-Han Cai1, Jun Wang2, Xiao-Lin Fang2

  • 1Nephrology Department in Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, Jiangxi, China.

Respiratory Medicine Case Reports
|August 17, 2021
PubMed

Insights

Microscopic polyangiitis patients on immunosuppressants can develop strongyloidiasis and nocardia infections. Consider strongyloidiasis in immunocompromised individuals with systemic symptoms, even without eosinophilia, and investigate mixed infections thoroughly.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Rheumatology

Background:

  • Microscopic polyangiitis (MPA) is an autoimmune disease often treated with corticosteroids and immunosuppressants.
  • Immunosuppressive therapy can increase the risk of opportunistic infections in patients with autoimmune conditions.

Observation:

  • A patient with microscopic polyangiitis developed severe infections, including strongyloidiasis, Nocardia, and Citrobacter freundii, following immunosuppressive treatment.
  • The patient presented with diverse systemic symptoms affecting digestive and respiratory systems.

Findings:

  • Strongyloidiasis should be considered in immunocompromised individuals from endemic areas presenting with gastrointestinal or respiratory symptoms, even in the absence of eosinophilia.
  • Mixed infections, such as those involving Nocardia, are common in this patient population and require diligent diagnostic efforts.

Implications:

  • Early and comprehensive diagnostic workup, employing multiple methods, is crucial for identifying opportunistic infections in immunosuppressed patients.
  • Prompt diagnosis and treatment of these infections can improve outcomes for patients with microscopic polyangiitis and other autoimmune diseases.
Keywords:
Citrobacter freundiiCorticosteroidsEosinophilsImmunocompromisedNocardiaStrongyloidiasis

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