Abstract
Introduction
Human strongyloidiasis is a generally neglected parasitic disease of major global distribution, spreading commonly in tropical and subtropical areas. As for China, strongyloidiasis occur mainly in South of China and no relevant information about the parasite infection in North China was available.
Case Presentation
An 84-year-old man from Shanxi province, North China, was admitted to Department of Nephrology with complaints of a 7-month history of intermittent edema of both lower extremity with foam urine and 3-day history of fever, chill and diarrhea. Large numbers of rhabditiform larva of Strongyloides stercoralis (S. stercoralis) were observed in a stool sample. Diagnosis of S. stercoralis infection was established by morphological observations of larvae under the microscope in both wet mount and Wright–Giemsa staining smear and further confirmed by molecular biology identification.
Conclusions
We report a rare case of S. stercoralis infection in a patient with chronic renal failure from North China, which implies the possibility of developing human strongyloidiasis in cooler climates. In addition, our case suggests that clinicians should consider the complication of S. stercoralis infection in immunosuppressed patient populations with chronic renal failure. Morphological details of S. stercoralis in Wright–Giemsa staining was first described in the present case. Our results also support the use of molecular techniques targeting COX1 gene sequence for the diagnosis of S. stercoralis infection, which was prove to be necessary in laboratory practice, especially for those inexperienced morphologists in temperature zone.
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References
Garcia LS, Bruckner DA (2016) Diagnostic medical parasitology. Clin Microbiol Newsl 16(14):322–325. https://doi.org/10.1128/9781555819002
Levenhagen MA, Costa-Cruz JM (2014) Update on immunologic and molecular diagnosis of human strongyloidiasis. Acta Trop 135:33–43. https://doi.org/10.1016/j.actatropica.2014.03.015
Wang C, Xu J, Zhou X, Li J, Yan G, James AA et al (2013) Strongyloidiasis: an emerging infectious disease in China. Am J Trop Med Hyg 88(3):420–425. https://doi.org/10.4269/ajtmh.12-0596
Rajapurkar M, Hegde U, Rokhade M, Gang S, Gohel K (2007) Respiratory hyperinfection with Strongyloides stercoralis in a patient with renal failure. Nat Clin Pract Nephrol 3(10):573–577. https://doi.org/10.1038/ncpneph0598
Arije A, Kadiri S, Osobamiro OA, Akinkugbe OO (1992) Chronic diarrhoea due to strongyloidiasis in a Nigerian with chronic renal failure: a case report. J Trop Med Hyg 95(5):354–355. PMID: 1404562
Wang LF, Xu L, Luo SQ, Xie H, Chen W, Wu ZD et al (2017) Diagnosis of Strongyloides stercoralis by morphological characteristics combine with molecular biological methods. Parasitol Res 116(4):1159–1163. https://doi.org/10.1007/s00436-017-5389-y
Concha R, Harrington W Jr, Rogers AI (2005) Intestinal strongyloidiasis: recognition, management, and determinants of outcome. J Clin Gastroenterol 39(3):203–211. https://doi.org/10.1097/01.mcg.0000152779.68900.33
Qu TT, Yang Q, Yu MH, Wang J (2016) A fatal Strongyloides stercoralis hyperinfection syndrome in a patient with chronic kidney disease: a case report and literature review. Medicine 95(19):e3638. https://doi.org/10.1097/MD.0000000000003638
Teixeira MC, Inês EJ, Pacheco FT, Silva RK, Mendes AV, Adorno EV, Lima FM, Soares NM (2010) Asymptomatic Strongyloides stercoralis hyperinfection in an alcoholic patient with intense anemia. J Parasitol 96(4):833–835. https://doi.org/10.1645/GE-2358.1
Kramme S, Nissen N, Soblik H, Erttmann K, Tannich E, Fleischer B et al (2011) Novel real-time PCR for the universal detection of Strongyloides species. J Med Microbiol 60(Pt 4):454–458. https://doi.org/10.1099/jmm.0.025338-0
Verweij JJ, Canales M, Polman K, Ziem J, Brienen EA, Polderman AM et al (2009) Molecular diagnosis of Strongyloides stercoralis in faecal samples using real-time PCR. Trans R Soc Trop Med Hyg 103(4):342–346. https://doi.org/10.1016/j.trstmh.2008.12.001
Formenti F, La Marca G, Perandin F, Pajola B, Romano M, Santucci B et al (2019) A diagnostic study comparing conventional and real-time PCR for Strongyloides stercoralis on urine and on faecal samples. Acta Trop 190:284–287. https://doi.org/10.1016/j.actatropica.2018.12.001
Acknowledgements
We would like to thank Man Luo (Associate Professor in Department of Clinical Laboratory Medicine, People's hospital of Xishuangbanna Dai Autonomous Prefecture) and Xi Sun (Associate Professor in Department of Parasitology of Zhongshan School of Medicine in Sun Yat-sen University; Key Laboratory of Tropical Disease Control in Sun Yat-sen University, Ministry of Education), for their help in morphology and molecular biology identification of the parasite, respectively.
Funding
Financial support for this study was received from The Natural Science Foundation of Shanxi Province Grants (201901D211511) and The Medical Research Foundation of Health Commission of Shanxi Province Grants (2019006).
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Yu, P., Wang, X., Wen, X. et al. Strongyloides stercoralis Infection in a Patient with Chronic Renal Failure from North China. Acta Parasit. 66, 1089–1092 (2021). https://doi.org/10.1007/s11686-021-00356-w
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DOI: https://doi.org/10.1007/s11686-021-00356-w