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Internist (Berl) ; 60(11): 1201-1208, 2019 Nov.
Article in German | MEDLINE | ID: mdl-31511906

ABSTRACT

This article reports about a 73-year-old woman of Bosnian descent who presented with acute renal failure. A renal biopsy was diagnostic for a postinfect necrotizing and extracapillary proliferative glomerulonephritis. The patient reported a febrile infection fever 2 weeks previously. The diagnostics did not reveal any indications of an ongoing infection. The glomerulonephritis responded to treatment with systemic steroids. The patient was readmitted to hospital 6 weeeks later in a severely ill condition. A gastric biopsy revealed a Strongyloides stercoralis infestation. Due to the systemic steroid therapy the patient had developed a so-called hyperinfection syndrome and died despite treatment on the intensive care unit. This case illustrates the need for awareness of this rare parasitosis, particularly in patients from endemic areas. A likely causal relationship with the glomerulonephritis is discussed and an overview of the diagnostics, course of the disease and treatment of this parasitosis is given.


Subject(s)
Acute Kidney Injury/etiology , Glomerulonephritis/drug therapy , Prednisolone/adverse effects , Steroids/adverse effects , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/diagnosis , Aged , Animals , Antiparasitic Agents/therapeutic use , Fatal Outcome , Female , Glomerulonephritis/diagnosis , Humans , Ivermectin/therapeutic use , Prednisolone/therapeutic use , Steroids/therapeutic use , Stomach/microbiology , Stomach/pathology , Strongyloidiasis/complications , Strongyloidiasis/drug therapy
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