Challenging differential diagnosis, Rare disease
Vaishnavi Pochineni, Darshan Lal, Shahed Hasnayen, Erfidia Restrepo
(Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, USA)
Am J Case Rep 2015; 16:603-605
Currently, it is normal to screen for Strongyloides as part of the workup in pre-transplant patients who have eosinophilia. Given the high mortality rates in Strongyloides hyperinfection, this article illustrates the need to screen all patients with eosinophilia who will be started on immunosuppression.
CASE REPORT: We present here an interesting case of a 76-year-old man with membranous glomerulopathy who developed a severe Strongyloides hyperinfection that required an ICU stay and ultimately led to his death a few weeks after initiation of cyclophosphamide and steroids.
CONCLUSIONS: We recommend that a detailed workup to detect or rule out this parasitic infection be conducted prior to the initiation of immunosuppression in any patient with eosinophilia.
Keywords: Animals, Aged, Eosinophilia - immunology, Fatal Outcome, Humans, Immunocompromised Host, Male, Strongyloides, Strongyloidiasis - diagnosis, Syndrome