Fatal Strongyloides stercoralis infection in a patient with chronic inflammatory demyelinating polyneuropathy

摘要

A 50-year-old villager with chronic inflammatory demyelinating polyradiculoneuropathy developed pain abdomen, diarrhea, and vomiting after 8 weeks of prednisolone (40 mg/day) therapy. After 10 weeks, he developed abdominal distension, leucocytosis, thrombocytopenia, liver dysfunction, coagulopathy, and respiratory failure. Stool examination showed larvae of Strongyloides stercoralis. He died in spite of antibiotics, metronidazole, ivermectin, vasopressor, and artificial ventilation. The patients on corticosteroid therapy are at risk of fatal septicemia due to Strongyloides stercoralis hyperinfection.