Volume 26, Number 3—March 2020
CME ACTIVITY - Synopsis
Clinical Characteristics of Disseminated Strongyloidiasis, Japan, 1975–2017
Table 2
Symptoms and clinical diagnoses of patients with disseminated strongyloidiasis, Okinawa Chubu Hospital, Uruma, Japan, 1975–2017
Characteristic | No. patients |
|||||||
---|---|---|---|---|---|---|---|---|
All patients |
Dissemination |
Occult dissemination with meningitis/enteric organisms |
Occult dissemination with culture-negative suppurative meningitis |
|||||
No. patients |
70 (100) |
32 (45.7) |
12 (17.1) |
26 (37.1) |
||||
Symptoms* | ||||||||
Fever | 37 (52.9) | 15 (46.9) | 8 (66.7) | 14 (53.8) | ||||
Headache | 23 (32.9) | 3 (9.4) | 7 (58.3) | 13 (50.0) | ||||
Altered mental status | 17 (24.3) | 7 (21.9) | 3 (25.0) | 7 (26.9) | ||||
Nausea or vomiting | 10 (14.3) | 4 (12.5) | 1 (8.3) | 5 (19.2) | ||||
Abdominal pain | 6 (8.6) | 2 (6.3) | 2 (16.7) | 2 (7.7) | ||||
Anorexia | 5 (7.1) | 4 (12.5) | 1 (8.3) | 0 (0) | ||||
Constipation | 1 (1.4) | 0 (0) | 1 (8.3) | 0 (0) | ||||
Diarrhea |
1 (1.4) |
0 (0) |
0 (0) |
1 (3.8) |
||||
Clinical diagnosis† | ||||||||
Full-blown dissemination‡ | 9 (12.9) | 9 (28.1) | 0 (0) | 0 (0) | ||||
Sepsis | 23 (32.9) | 13 (40.6) | 7 (58.3) | 3 (11.5) | ||||
Meningitis (enteric) | 22 (31.4) | 10 (31.3) | 12 (100) | 0 (0) | ||||
Meningitis (culture-negative) | 34 (48.6) | 8 (25) | 0 (0) | 26 (100) | ||||
Pneumonia | 27 (38.6) | 26 (81.3) | 0 (0) | 1 (3.8) | ||||
Paralytic ileus | 17 (24.3) |
15 (46.9) |
1 (8.3) |
1 (3.8) |
*Other symptoms that were only noted in patients with dissemination included cough (2 cases), and rash, fatigue, convulsion, and syncope (1 case each).
†Other diagnoses that were only identified in patients with dissemination included peritonitis (6 cases), dermatitis (5 cases), and esophagitis (1 case).
‡Full-blown dissemination is the severest form of dissemination and hyperinfection, referring to patients with paralytic ileus and pneumonia caused by enteric organisms, as well as either sepsis or meningitis caused by enteric organisms.