Case 42: A 61 year old returned solder with abdominal pain Flashcards
What are the symptoms of a round worm infection?
Colicky abdominal pain and diarrhoea
Nausea and vomiting
Recent diagnosis of chronic lymphocytic leukaemia
Is there growth on MAC agar for roundworm?
No - just normal flora
How is strongyloides contracted?
Enters through exposed skin → blood → resp. tract → swallowed, etc.
Which stage of the strongyloides life cycle infects humans?
Infective flariform larvae
Which stage of the strongyloides life cycle do we see in specimens from patients?
Rhabditfor
Why does strongyloides infection result in persistent infection?
Because it has an autoinfection component in its lifecycle
What does autoinfection from strongyloides result in?
Increasing worm burden
Why do patients with strongyloides infections suffer from a high incidence of Gram negative septicaemia and mortality?
During hyperinfection phase, multiple breaches of intestinal mucosa result from the continuous larval migration, facilitating passage of gut microbiota through the bowel and into the tissues and circulation.
Why would a patient who has hosted strongyloides for 20 years only suddenly present with symptoms?
Because they’re immunosuppressed → hyperinfection cycle → septicaemia and death
What should you test for before immunosuppressing a patient?
Strongyloides
