Rapid development of migratory, linear, and serpiginous lesions in association with immunosuppression
Key teaching points • Strongyloides is a genus of obligate gastrointestinal nematodes (roundworms) of vertebrates. The species stercoralis , the usual cause of human infection, has the potential for autoinfection and multiplication in human beings. • Peripheral eosinophilia without a known cause may...
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| Veröffentlicht in: | Journal of the American Academy of Dermatology 2014-06, Vol.70 (6), p.1130-1134 |
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| creator | Pichard, Dominique C., MD Hensley, Jennifer R., MD Williams, Esther, BS Apolo, Andrea B., MD Klion, Amy D., MD DiGiovanna, John J., MD |
| description | Key teaching points • Strongyloides is a genus of obligate gastrointestinal nematodes (roundworms) of vertebrates. The species stercoralis , the usual cause of human infection, has the potential for autoinfection and multiplication in human beings. • Peripheral eosinophilia without a known cause may represent chronic, persistent infection with Strongyloides stercoralis. • Undiagnosed disease is prevalent, especially among immigrants and military veterans who served in highly endemic areas in the tropics and subtropics. • Immunosuppression of individuals with persistent Strongyloides stercoralis infection can lead to hyperinfection syndrome or disseminated infection, which can be fatal in up to 90% of cases. • First-line therapy for acute and chronic strongyloidiasis is ivermectin, 200 μg/kg orally in a single daily dose for 1 to 2 days. Treatment of hyperinfection syndrome includes reduction of immunosuppression, if possible, and administration of ivermectin (200 μg/kg daily) until larvae are no longer detected in stool for at least 2 weeks.3,17 The spectrum of clinical disease is wide, however, and shorter courses of ivermectin may be sufficient. • Larva currens is a hypersensitivity reaction that refers to the cutaneous manifestation of Strongyloides and should be distinguished from cutaneous larva migrans, which is caused by abortive human infection with an animal hookworm. |
| doi_str_mv | 10.1016/j.jaad.2013.11.036 |
| format | Article |
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The species stercoralis , the usual cause of human infection, has the potential for autoinfection and multiplication in human beings. • Peripheral eosinophilia without a known cause may represent chronic, persistent infection with Strongyloides stercoralis. • Undiagnosed disease is prevalent, especially among immigrants and military veterans who served in highly endemic areas in the tropics and subtropics. • Immunosuppression of individuals with persistent Strongyloides stercoralis infection can lead to hyperinfection syndrome or disseminated infection, which can be fatal in up to 90% of cases. • First-line therapy for acute and chronic strongyloidiasis is ivermectin, 200 μg/kg orally in a single daily dose for 1 to 2 days. Treatment of hyperinfection syndrome includes reduction of immunosuppression, if possible, and administration of ivermectin (200 μg/kg daily) until larvae are no longer detected in stool for at least 2 weeks.3,17 The spectrum of clinical disease is wide, however, and shorter courses of ivermectin may be sufficient. • Larva currens is a hypersensitivity reaction that refers to the cutaneous manifestation of Strongyloides and should be distinguished from cutaneous larva migrans, which is caused by abortive human infection with an animal hookworm.</description><identifier>ISSN: 0190-9622</identifier><identifier>EISSN: 1097-6787</identifier><identifier>DOI: 10.1016/j.jaad.2013.11.036</identifier><identifier>PMID: 24831316</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Animals ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; autoinfection ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - immunology ; Carcinoma, Squamous Cell - secondary ; Dermatology ; Female ; Follow-Up Studies ; Humans ; hyperinfection ; Immunocompromised Host ; immunosuppression ; ivermectin ; Ivermectin - therapeutic use ; larva currens ; larva migrans ; nematode ; Neoplasms, Unknown Primary - immunology ; Neoplasms, Unknown Primary - pathology ; Risk Assessment ; roundworm ; Skin Diseases, Parasitic - diagnosis ; Skin Diseases, Parasitic - drug therapy ; Skin Neoplasms - drug therapy ; Skin Neoplasms - immunology ; Skin Neoplasms - secondary ; Strongyloides stercoralis ; Strongyloides stercoralis - isolation & purification ; strongyloidiasis ; Strongyloidiasis - diagnosis ; Strongyloidiasis - drug therapy ; Superinfection - diagnosis ; Superinfection - drug therapy ; Superinfection - immunology ; Teaching Rounds ; Treatment Outcome</subject><ispartof>Journal of the American Academy of Dermatology, 2014-06, Vol.70 (6), p.1130-1134</ispartof><rights>American Academy of Dermatology, Inc.</rights><rights>2014 American Academy of Dermatology, Inc.</rights><rights>2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-991f8fa1232c9e3a3f289114602c0c2529305775f123c8ccac905032f3152eb53</citedby><cites>FETCH-LOGICAL-c510t-991f8fa1232c9e3a3f289114602c0c2529305775f123c8ccac905032f3152eb53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0190962213012942$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24831316$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pichard, Dominique C., MD</creatorcontrib><creatorcontrib>Hensley, Jennifer R., MD</creatorcontrib><creatorcontrib>Williams, Esther, BS</creatorcontrib><creatorcontrib>Apolo, Andrea B., MD</creatorcontrib><creatorcontrib>Klion, Amy D., MD</creatorcontrib><creatorcontrib>DiGiovanna, John J., MD</creatorcontrib><title>Rapid development of migratory, linear, and serpiginous lesions in association with immunosuppression</title><title>Journal of the American Academy of Dermatology</title><addtitle>J Am Acad Dermatol</addtitle><description>Key teaching points • Strongyloides is a genus of obligate gastrointestinal nematodes (roundworms) of vertebrates. The species stercoralis , the usual cause of human infection, has the potential for autoinfection and multiplication in human beings. • Peripheral eosinophilia without a known cause may represent chronic, persistent infection with Strongyloides stercoralis. • Undiagnosed disease is prevalent, especially among immigrants and military veterans who served in highly endemic areas in the tropics and subtropics. • Immunosuppression of individuals with persistent Strongyloides stercoralis infection can lead to hyperinfection syndrome or disseminated infection, which can be fatal in up to 90% of cases. • First-line therapy for acute and chronic strongyloidiasis is ivermectin, 200 μg/kg orally in a single daily dose for 1 to 2 days. Treatment of hyperinfection syndrome includes reduction of immunosuppression, if possible, and administration of ivermectin (200 μg/kg daily) until larvae are no longer detected in stool for at least 2 weeks.3,17 The spectrum of clinical disease is wide, however, and shorter courses of ivermectin may be sufficient. • Larva currens is a hypersensitivity reaction that refers to the cutaneous manifestation of Strongyloides and should be distinguished from cutaneous larva migrans, which is caused by abortive human infection with an animal hookworm.</description><subject>Aged</subject><subject>Animals</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>autoinfection</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - immunology</subject><subject>Carcinoma, Squamous Cell - secondary</subject><subject>Dermatology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>hyperinfection</subject><subject>Immunocompromised Host</subject><subject>immunosuppression</subject><subject>ivermectin</subject><subject>Ivermectin - therapeutic use</subject><subject>larva currens</subject><subject>larva migrans</subject><subject>nematode</subject><subject>Neoplasms, Unknown Primary - immunology</subject><subject>Neoplasms, Unknown Primary - pathology</subject><subject>Risk Assessment</subject><subject>roundworm</subject><subject>Skin Diseases, Parasitic - diagnosis</subject><subject>Skin Diseases, Parasitic - drug therapy</subject><subject>Skin Neoplasms - drug therapy</subject><subject>Skin Neoplasms - immunology</subject><subject>Skin Neoplasms - secondary</subject><subject>Strongyloides stercoralis</subject><subject>Strongyloides stercoralis - isolation & purification</subject><subject>strongyloidiasis</subject><subject>Strongyloidiasis - diagnosis</subject><subject>Strongyloidiasis - drug therapy</subject><subject>Superinfection - diagnosis</subject><subject>Superinfection - drug therapy</subject><subject>Superinfection - immunology</subject><subject>Teaching Rounds</subject><subject>Treatment Outcome</subject><issn>0190-9622</issn><issn>1097-6787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2L1TAQhoso7nH1D3ghufRiW2eSfgVkQRa_YEHw4zpk0-nZ1DapSXvk_HtTzrqoF16FkGfeZPJMlj1HKBCwfjUUg9ZdwQFFgViAqB9kOwTZ5HXTNg-zHaCEXNacn2VPYhwAQJaieZyd8bIVKLDeZfRZz7ZjHR1o9PNEbmG-Z5PdB734cLxgo3WkwwXTrmORwmz31vk1spGi9S4y65iO0Rurl7RnP-1yy-w0rc7HdZ4DxQ17mj3q9Rjp2d16nn179_br1Yf8-tP7j1dvrnNTISy5lNi3vUYuuJEktOh5KxHLGrgBwysuBVRNU_WJMK0x2kioQPBeYMXpphLn2eUpd15vJupMaifoUc3BTjoclddW_X3i7K3a-4MqgZdYbwEv7wKC_7FSXNRko6Fx1I5S1worIcu65igSyk-oCT7GQP39NQhq86MGtflRmx-FqJKfVPTizwfel_wWkoDXJ4DSNx0sBRWNJWeos4HMojpv_59_-U-5SQKt0eN3OlIc_BpcEqBQRa5AfdkmZBsQFIBcllz8AvGeuBs</recordid><startdate>20140601</startdate><enddate>20140601</enddate><creator>Pichard, Dominique C., MD</creator><creator>Hensley, Jennifer R., MD</creator><creator>Williams, Esther, BS</creator><creator>Apolo, Andrea B., MD</creator><creator>Klion, Amy D., MD</creator><creator>DiGiovanna, John J., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140601</creationdate><title>Rapid development of migratory, linear, and serpiginous lesions in association with immunosuppression</title><author>Pichard, Dominique C., MD ; Hensley, Jennifer R., MD ; Williams, Esther, BS ; Apolo, Andrea B., MD ; Klion, Amy D., MD ; DiGiovanna, John J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-991f8fa1232c9e3a3f289114602c0c2529305775f123c8ccac905032f3152eb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Animals</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>autoinfection</topic><topic>Carcinoma, Squamous Cell - drug therapy</topic><topic>Carcinoma, Squamous Cell - immunology</topic><topic>Carcinoma, Squamous Cell - secondary</topic><topic>Dermatology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>hyperinfection</topic><topic>Immunocompromised Host</topic><topic>immunosuppression</topic><topic>ivermectin</topic><topic>Ivermectin - therapeutic use</topic><topic>larva currens</topic><topic>larva migrans</topic><topic>nematode</topic><topic>Neoplasms, Unknown Primary - immunology</topic><topic>Neoplasms, Unknown Primary - pathology</topic><topic>Risk Assessment</topic><topic>roundworm</topic><topic>Skin Diseases, Parasitic - diagnosis</topic><topic>Skin Diseases, Parasitic - drug therapy</topic><topic>Skin Neoplasms - drug therapy</topic><topic>Skin Neoplasms - immunology</topic><topic>Skin Neoplasms - secondary</topic><topic>Strongyloides stercoralis</topic><topic>Strongyloides stercoralis - isolation & purification</topic><topic>strongyloidiasis</topic><topic>Strongyloidiasis - diagnosis</topic><topic>Strongyloidiasis - drug therapy</topic><topic>Superinfection - diagnosis</topic><topic>Superinfection - drug therapy</topic><topic>Superinfection - immunology</topic><topic>Teaching Rounds</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pichard, Dominique C., MD</creatorcontrib><creatorcontrib>Hensley, Jennifer R., MD</creatorcontrib><creatorcontrib>Williams, Esther, BS</creatorcontrib><creatorcontrib>Apolo, Andrea B., MD</creatorcontrib><creatorcontrib>Klion, Amy D., MD</creatorcontrib><creatorcontrib>DiGiovanna, John J., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Academy of Dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pichard, Dominique C., MD</au><au>Hensley, Jennifer R., MD</au><au>Williams, Esther, BS</au><au>Apolo, Andrea B., MD</au><au>Klion, Amy D., MD</au><au>DiGiovanna, John J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rapid development of migratory, linear, and serpiginous lesions in association with immunosuppression</atitle><jtitle>Journal of the American Academy of Dermatology</jtitle><addtitle>J Am Acad Dermatol</addtitle><date>2014-06-01</date><risdate>2014</risdate><volume>70</volume><issue>6</issue><spage>1130</spage><epage>1134</epage><pages>1130-1134</pages><issn>0190-9622</issn><eissn>1097-6787</eissn><abstract>Key teaching points • Strongyloides is a genus of obligate gastrointestinal nematodes (roundworms) of vertebrates. The species stercoralis , the usual cause of human infection, has the potential for autoinfection and multiplication in human beings. • Peripheral eosinophilia without a known cause may represent chronic, persistent infection with Strongyloides stercoralis. • Undiagnosed disease is prevalent, especially among immigrants and military veterans who served in highly endemic areas in the tropics and subtropics. • Immunosuppression of individuals with persistent Strongyloides stercoralis infection can lead to hyperinfection syndrome or disseminated infection, which can be fatal in up to 90% of cases. • First-line therapy for acute and chronic strongyloidiasis is ivermectin, 200 μg/kg orally in a single daily dose for 1 to 2 days. Treatment of hyperinfection syndrome includes reduction of immunosuppression, if possible, and administration of ivermectin (200 μg/kg daily) until larvae are no longer detected in stool for at least 2 weeks.3,17 The spectrum of clinical disease is wide, however, and shorter courses of ivermectin may be sufficient. • Larva currens is a hypersensitivity reaction that refers to the cutaneous manifestation of Strongyloides and should be distinguished from cutaneous larva migrans, which is caused by abortive human infection with an animal hookworm.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24831316</pmid><doi>10.1016/j.jaad.2013.11.036</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Aged Animals Antineoplastic Combined Chemotherapy Protocols - therapeutic use autoinfection Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - immunology Carcinoma, Squamous Cell - secondary Dermatology Female Follow-Up Studies Humans hyperinfection Immunocompromised Host immunosuppression ivermectin Ivermectin - therapeutic use larva currens larva migrans nematode Neoplasms, Unknown Primary - immunology Neoplasms, Unknown Primary - pathology Risk Assessment roundworm Skin Diseases, Parasitic - diagnosis Skin Diseases, Parasitic - drug therapy Skin Neoplasms - drug therapy Skin Neoplasms - immunology Skin Neoplasms - secondary Strongyloides stercoralis Strongyloides stercoralis - isolation & purification strongyloidiasis Strongyloidiasis - diagnosis Strongyloidiasis - drug therapy Superinfection - diagnosis Superinfection - drug therapy Superinfection - immunology Teaching Rounds Treatment Outcome |
| title | Rapid development of migratory, linear, and serpiginous lesions in association with immunosuppression |
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