Articles: parasitic-lung-diseases.
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The 15th known case of systemic Strongyloidiasis in an AIDS patient is recorded, with emphasis on the fulminant clinical cause and diffuse organ involvement.
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A 35-year-old man presented with cough, expectoration of green sputum, and right-sided pleuritic chest pain. Symptoms had begun the previous day and he had vomited the night before. The patient also complained of chronic fatigue, a 12-lb. weight loss, insomnia, right-sided back pain, and lower extremity myalgias. He denied having had fever, chills, diaphoresis, dyspnea, diarrhea, dysuria, abdominal pain, skin lesions, or jaundice.
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We evaluated 20 patients with pulmonary strongyloidiasis for risk factors, clinical and imaging manifestations, complications, treatment, and outcome. Eighteen (90%) had risk factors for strongyloidiasis including steroid use, age greater than 65, chronic lung disease, use of histamine blockers, or chronic debilitating illness. Pulmonary signs and symptoms, including cough, shortness of breath, wheezing, and hemoptysis, were present in 19 (95%); adult respiratory distress syndrome (ARDS) developed in 9 (45%). ⋯ All were treated with thiabendazole, 25 mg/kg twice daily; on average, patients without ARDS were treated for 3 days, versus 7 days for those with ARDS. Seventy percent responded to therapy; 30% died. Preexisting chronic lung disease and ARDS were statistically significant predictors of a poor prognosis.