• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.518-524
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• 1993

저자 등은 만성질환으로 인해 영양결핍 및 면역저하상태로 생각되는 75세 폐결핵환자에서 분선충의 대량의 자가감염을 객담, 분변에서 확인하여 치료하였으나 사망한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제68권1호
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• pp.29-33
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• 2010

Strongyloides stercoralis is an intestinal nematode that is a parasite to humans. The infecting filariform larvae of S. stercoralis enters the host body via the bloodstream, passes through the lungs, penetrates the alveoli, and then ascends the airway to transit down the esophagus into the small bowel. The infection can persist for decades without causing major symptoms and can elicit eosinophilia of varying magnitudes. Of note, this infection can also develop into a disseminated, often fatal, disease (hyperinfection) in patients receiving immunosuppressive corticosteroids. A 65-year-old man who was receiving corticosteroid therapy for the treatment of spinal stenosis was admitted to the emergency room with complaints of abdominal pain and severe dyspnea. We detected many S. stercoralis larvae in the sputum and in the bronchoalveolar-lavage sample collected by bronchoscopy. Here, we report a fatal case of strongyloidiasis with acute respiratory failure and intestinal perforation. In addition, we provide a brief review of the relevant medical literature.

• Parasites, Hosts and Diseases
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• 제32권1호
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• pp.49-52
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• 1994

1990년 4월부터 1992년 2월까지 인제대 부속 서울 백병원과 상계 백병원에 내원한 환자 중 대변에서 분선충(Strongwloides stercoralis)의 rhabditoid 유충 또는 기생세대 자충이 검출된 분선충 감염증 9례를 보고하고자 한다. 환자들은 50대와 70대 사이의 남자 7명 및 여자 2명으로 퇴행성 관절염으로 스테로이드계 약물을 장기 복용하였거나 소화기 장애, 고혈압, 간질환 정신장애 등 다양한 질환을 동반하고 있었다. 관절염, 소화기 장애 등으로 입원한 57세 여자 환자 1례에서는 albendazole 및 mebendazole 투여 4-5일 째의 설사변에서 분선충의 기생세대 자충 (parasitic females) 220마리가 회수되었다. 이 환자는 관절염에 대한 스테로이드 장기 복용으로 면역기능이 저하된 상태에서 자가감염된 중감염(hyperinfection) 예로서 우리 나라에서 기생세대 자충이 확인된 세 번째 증례이기도 하다.

• Parasites, Hosts and Diseases
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• 제26권3호
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• pp.221-226
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• 1988

면역기능이 저하된 한국인 73세 남자가 요통을 주소로 입원하였다. 환자는 prednisolone 을 장기간 투여하였다고 하며 입원시 전신성 pitting edema와 기침, 객담, 구토, 설사를 하였고 빈 사상태였다. 백혈구는 증가하였으나 초산구중가증은 없었으며 저 단백혈증, hypoalbuminemia, 패혈증, 빈혈이 있었다. 뇨는 한색이었다. 대변검사에서 rhabditiform 유충이 관찰되었으며 대변 배양 검사로 분선충의 filariform유충이 확인되어 분선충에 의한 hyperinfection으로 진단되었다. 치료목적으로 입원 제3일부터 albendazole을 4일간 투여하였다. 입원 제7일에 객담검사에서 filariform유충이 관찰되었으며 설사변에서 분선충의 기생세대 자충 619마리를 수집하였다. 그러나 환자는 희망없이 빈사상태로 퇴원하였으며 얼마 후 자택에서 사망하였다.

• Parasites, Hosts and Diseases
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• 제41권1호
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• pp.63-67
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• 2003

A 69-year-old Korean man was admitted to emergency room with complaints of abdominal pain, vomiting, and diarrhea, Laboratory tests revealed eosinophilia, anemia, hypoproteinemia, and hyponatremia. The gastric mucosa showed whitish mottled and slightly elevated lesions on the body angle of antrum. Microscopically, chronic gastritis with incomplete intestinal metaplasia was observed. Many adult worms, larvae, and eggs in cross sections were located in the crypts. Furthermore, the filariform larvae of Strongyloides stercoralis with a notched tail were detected through the culture.

• Parasites, Hosts and Diseases
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• 제43권2호
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• pp.51-55
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• 2005

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured $269\pm21.2{\mu}m$ in length and $11\pm0.6{\mu}m$ in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.

• Parasites, Hosts and Diseases
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• 제23권2호
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• pp.236-240
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• 1985

A case of Strongyloides stercoralis infection was experienced in a 73-year old Korean female patient, was hospitalized with relapse of cholecystitis. The patient developed cough and dyspnea 17 days after the admission. On the 27th hospitalized day, diarrhoea, nausea, vomiting and abdominal pain started. A number of parasitic larvae were incubated at $25^{\circ}C$ for 2 days. Typical fork tailed filariform larvae of S. stercoralis (Bavay, 1876) Stiles and Hassall, 1902, were identified after cultivation. There was no improvement of diarrhoea after the medication with mebendasole. After the administration of thiabendazole, however, diarrhoea was stopped. On the 6th day of medication, S. stercoralis larvae was no more detected, and thereafter no larva was observed by repeated stool examinations upto 2 months after chemotherapy. The patient had the history of administration of steroid for articular rheumatism. Therfore this ,case seems to be a hyperinfection of S. stercoralis due to an autoinfection and to be the first report on the hyperinfected strongyloidiasis in Korea. Related literature was briefly reviewed.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.200-203
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• 2018

Strongyloides stercoralis is an intestinal nematode that occurs sporadically in temperate areas like Korea. People who are in the immunosuppressed state, over the age of 65 or under the corticosteroid therapy are at risk for developing Strongyloides hyperinfection syndrome. Acute respiratory distress syndrome (ARDS) with alveolar hemorrhage is a rare presentation of Strongyloides hyperinfection. A 78-year-old man had been irregularly injected corticosteroid on his knees, but did not have any immunosuppressive disease. He was initially diagnosed with ARDS and septic shock. Bronchoalveolar lavage (BAL) fluid was bloody and its cytology revealed helminthic larvae identified as S. stercoralis. Results of Cytomegalovirus polymerase chain reaction (PCR), Pneumocystis jirovecii PCR, and Aspergillus antigen testing of the BAL fluid were positive. The clinical progress quickly deteriorated with multiple organ failure, shock and arrhythmia, so he finally died. This is a rare case of ARDS in an older patient without any known immunosuppressive conditions, with alveolar hemorrhage and S. stercoralis being found via BAL.

• Parasites, Hosts and Diseases
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• 제52권2호
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• pp.215-220
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• 2014

We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples.

• 농촌의학ㆍ지역보건
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• 제15권1호
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• pp.49-55
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• 1990

Zoonoses are those diseases and infections that are naturally transmitted between vertebrate animals and man. At present, approximately 175 diseases caused by virus, rickettsia, bacteria, protozoa and helminthes as well as some of arthropods and the number is continually increasing. Although zoonoses are generally recognized as significant health problems, the actual prevalence and incidence of zoonotic infections is difficult to determine. Medical services in a rural area are scarce and ill persons may have little chance to see a physician. Furthermore, a lack of physician awareness and of appropriate diagnostic support is made often misdiagnosis. In rural Korea, parasitic disease is still important subject in the field of zoonotic infections considering its number and morbidity. Recently there was conspicuous reduction of soil-transmitted parasitic diseases (i.e. ascariasis. hookworms, trichuriasis), but clonorchiasis. intestinal trematodiases and taeniasis are a considerable problem. This is often significantly related to human behavioral patterns based on socio-economic and cultural conditions and linked with the local biologic and physical environment. The most of all parasitic zoonoses to man and animals are the food-transmitted parasitic diseases, and domestic animals such as dog, cat, pig, as well as fat and some mammals, ruminants and birds are act as reservoir hosts. In the present topics, current problems of parasitic zoonoses caused by protozoan infections (i. e. toxoplasmosis, pneumocystosis and cryptosporidiosis) which are the most common opportunistic in AIDS or immunocompromised persons, trematode infections (i.e. clonorchiasis, paragonimiasis and some intestinal tremadodiases). cestode infections such as cysticercosis and sparganosis, and some nematode infections of anisakiasis, thelaziasis and strongyloidiasis, are discussed here those on the occurrence in man and animals and the source of transmission as well as prevention and control measures in Korea.