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Chronic strongyloidiasis: a case of B symptoms and recurrent asthma exacerbations
  1. Zara Latif1 and
  2. Marc J Crupie2
  1. 1Department of Internal Medicine, BIDMC, Boston, Massachusetts, USA
  2. 2Department of Family Medicine, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
  1. Correspondence to Dr Zara Latif; zlatif1{at}uthsc.edu

Abstract

Strongyloidiasis is one of the neglected helminths infection that is often underdiagnosed and undertreated. Due to its variable presentation, its diagnosis is often a challenge. We report a case of an immigrant patient with asthma who later developed eosinophilia. After 3 years of unexplained eosinophilia, he developed B symptoms and had frequent asthma exacerbations. He was later diagnosed with strongyloidiasis and treated with ivermectin. His B symptoms resolved, and his asthma exacerbations decreased significantly. Due to the frequent use of corticosteroids in asthma exacerbations, this case illustrates the importance of Strongyloides screening in asthmatics from high-risk regions. It also displays the importance of further investigating patients with asthma who develop eosinophilia and have frequent exacerbations while on optimal asthma treatment. Having a high index of suspicion is essential when making this diagnosis, as clinical presentation is often variable and does not follow a standard time course.

  • tropical medicine (infectious disease)
  • asthma
  • general practice / family medicine

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Footnotes

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  • Contributors All listed authors meet the criteria for authorship as detailed below. ZL: planning, drafting and editing of the manuscript. MJC: provided patient care and editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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