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Emerg Infect Dis ; 26(3): 401-408, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32091375

RESUMO

Clinical characteristics of disseminated strongyloidiasis, the severest form of strongyloidiasis, are not well described. We conducted a retrospective, consecutive chart review of patients with disseminated strongyloidiasis admitted to Okinawa Chubu Hospital in Okinawa, Japan, during January 1975-December 2017. The 70 patients were classified into 3 clinical phenotypes: dissemination (32 patients [45.7%]), occult dissemination with meningitis caused by enteric organisms (12 patients [17.1%]), and occult dissemination with culture-negative suppurative meningitis (26 patients [37.1%]). Associated mortality rates were 56.3%, 16.7%, and 11.5%, respectively, and sepsis occurred in 40.6%, 58.3%, and 11.5% of cases, respectively. Common symptoms included fever (52.9% of patients), headache (32.9%), and altered mental status (24.3%). Patients were treated with thiabendazole (before 2003) or ivermectin (after 2003). Our findings show that disseminated strongyloidiasis has clinical phenotypes in terms of severity and that identification of occult dissemination, a mild form with prominent neurologic manifestations, is lifesaving.


Assuntos
Meningites Bacterianas/epidemiologia , Estrongiloidíase/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Helmínticos/uso terapêutico , Feminino , Humanos , Ivermectina/uso terapêutico , Japão/epidemiologia , Masculino , Prontuários Médicos , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/etiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/etiologia , Tiabendazol/uso terapêutico , Adulto Jovem
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