{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:41:27Z","timestamp":1790214087714,"version":"4.1.0"},"reference-count":29,"publisher":"Microbiology Society","issue":"9","license":[{"start":{"date-parts":[[2018,9,1]],"date-time":"2018-09-01T00:00:00Z","timestamp":1535760000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,1]]},"abstract":"<jats:p>\n                  <jats:bold>Introduction.<\/jats:bold> Strongyloidiasis is a neglected tropical disease with global prevalence. Under some cases of immune suppression (especially with corticosteroid administration), the nematode involved disseminates, leading to an amplified, possibly lethal hyper-infection syndrome.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Case presentation.<\/jats:bold> A 56-year-old Nepalese man presenting with chief complaints of nausea, vomiting, joint pain and abdominal cramps was admitted to Sumeru Hospital. His past history revealed: chronic obstructive pulmonary disease (COPD), systemic hypertension and previously treated pulmonary tuberculosis. The patient had been treated with oral prednisolone (60\u2009mg gl<jats:sup>\u22121<\/jats:sup>) for 8\u2009days due to a presumed exacerbation of his COPD. Sequentially, he developed haemoptysis, chest tightness, frequent wheezing and worsening cough. Bronchoscopy showed severe diffuse alveolar haemorrhage; microbiological examination of broncho-alveolar lavage (BAL) was recommended. Examination of an acid fast bacilli stain preparation of BAL revealed filariform larvae of <jats:italic>Strongyloides<\/jats:italic>. Stool specimen examination revealed larvae of <jats:italic>Strongyloides.<\/jats:italic> The physical condition of the patient began to deteriorate; a few days after admission, vancomycin-sensitive <jats:italic>Enterococcus faecium<\/jats:italic> was isolated from a blood sample. He was treated with ivermectin and albendazole for strongyloides and linezolid plus vancomycin for <jats:italic>E. faecium<\/jats:italic>. However, the patient failed to recover from the illness and died.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion.<\/jats:bold> The findings of our study suggest that corticosteroid administration in strongyloidiasis can lead to the development of fatal strongyloides hyper-infection syndrome. Hence our experience suggests the need for early diagnosis of strongyloidiasis to avoid such an outcome. A deterioration of the patient's condition after the initiation of corticosteroid therapy in endemic areas should raise the possibility of strongyloidiasis.<\/jats:p>","DOI":"10.1099\/jmmcr.0.005165","type":"journal-article","created":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T20:06:44Z","timestamp":1536696404000},"source":"Crossref","is-referenced-by-count":17,"title":["Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease"],"prefix":"10.1099","volume":"5","author":[{"given":"Priyatam","family":"Khadka","sequence":"first","affiliation":[{"name":"2\u200bMedical Microbiology, Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal"},{"name":"1\u200bMedical Laboratory, Sumeru Hospital, Dhapakhel, Lalitpur, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratap","family":"Khadka","sequence":"additional","affiliation":[{"name":"3\u200bBiotechnology, Tribhuvan University, Kathmandu, 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