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Clinical Investigations: Bronchial ReactivityThe Prevalence and Response to Therapy of Strongyloides stercoralis in Patients With Asthma From Endemic Areas
Section snippets
Methods
The study was approved by the Santa Clara Valley Medical Center Research and Human Subjects Review Committee. From February 1992 through May 1993, we prospectively evaluated ambulatory and hospitalized patients referred to the Division of Respiratory Medicine for the management of asthma. All patients underwent a complete history and physical examination. The history focused on the country of origin, date of immigration to the United States, onset of asthma, history of corticosteroid treatment,
Results
A total of 45 patients, whose ages ranged from 20 to 76 years, were studied. Patient characteristics are listed in Table 1. Five patients (11 percent), including one eventually proved to have S stercoralis were previously intubated for status asthmaticus. Five patients (11 percent), all without S stercoralis smoked at least 10 pack-years. Table 2 shows the region of origin for all patients.
Fecal examination revealed the presence of S stercoralis larvae in five patients (11 percent). Two of
Discussion
Sporadic reports have linked the presence of S stercoralis infection with asthma.6, 7, 8, 9 Furthermore, corticosteroid-induced immunosuppression has led to overwhelming disseminated S stercoralis infection, bacterial superinfections, and death in patients with airflow obstruction and in patients who have received organ transplants with active S stercoralis infection.10, 11, 12, 13, 14 To design appropriate treatment and avoid disastrous consequences of corticosteroid-induced immunosuppression,
ACKNOWLEDGMENT
The authors thank Dr. John Hamilton and the staff in the Clinical Microbiology Lab at the Santa Clara Valley Medical Center and Janet Fried at the Centers for Disease Control and Prevention for their technical assistance.
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