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Medical Science Monitor Basic Research


The Worm that Clogs the Lungs: Strongyloides Hyper-Infection Leading to Fatal Acute Respiratory Distress Syndrome (ARDS)

Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology

Christopher Nnaoma, Ogechukwu Chika-Nwosuh, Christian Engell

USA Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, NJ, USA

Am J Case Rep 2019; 20:377-380

DOI: 10.12659/AJCR.914640

Available online:

Published: 2019-03-22


BACKGROUND: Strongyloides stercoralis is an intestinal helminth. Parasitism is caused by penetration of the larvae through the skin. It is endemic in tropical and subtropical regions of the world and in the United States occurs in the southeastern region. It has a tendency to remain dormant or progress to a state of hyper-infection during immunosuppression.
CASE REPORT: We present the case of a 70-year-old Nigerian who developed fatal ARDS secondary to Strongyloides infection after been treated with steroids for treatment of autoimmune necrotizing myopathy. Despite adequate management with mechanical ventilation and appropriate antifungal therapy, the patient died on day 19 of hospitalization.
CONCLUSIONS: S. stercoralis is known to affect every organ in the body. ARDS is often an overlooked complication of Strongyloides hyper-infection, which is often deadly. Immediate diagnosis and treatment are important for patient survival.

Keywords: Methylprednisolone, Respiratory Distress Syndrome, Adult, Strongyloides