Co-infection with Strongyloides stercoralis hyperinfection syndrome and Klebsiella in a nephrotic syndrome patient: A case report

This report describes a fatal S stercoralis hyperinfection in a patient with nephrotic syndrome after treatment with steroids. Patient concerns: A 70-year-old male presented with a history of progressive edema, skin infection, persistent fever, cough, intermittent abdominal pain, and progressive respiratory failure after steroid treatment. Diagnosis: Nephrotic syndrome; cellulitis; S stercoralis hyperinfection; Klebsiella pneumonia. Interventions: During the first hospital admission, the patient was administered full-dose glucocorticoid and antibiotic therapy after suffering from cellulitis. During the second admission, he was diagnosed and treated for normal digestive discomfort and a bacterial infection. The patient had progressive respiratory failure and was placed on a ventilator. He was immediately treated with albendazole when S stercoralis was found in samples of his sputum and feces. Outcomes: The patient died despite treatment with albendazole and antibiotic therapy. Lessons: It is essential to consider the possibility of S stercoralis infection in immunosuppressed patients with nephrotic syndrome. Given the lack of classic manifestations and high mortality rate of advanced disease, continuous monitoring, early diagnosis, and proper treatment are imperative.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research