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1994-09-19
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Document 0370
DOCN M9490370
TI Pathogenesis of human strongyloidiasis: autopsy and quantitative
parasitological analysis.
DT 9411
AU Haque AK; Schnadig V; Rubin SA; Smith JH; Department of Pathology and
Radiology, University of Texas; Medical Branch at Galveston.
SO Mod Pathol. 1994 Apr;7(3):276-88. Unique Identifier : AIDSLINE
MED/94336617
AB The distribution of pathologic lesions and the parasite burden of major
organs were studied in seven patients with disseminated strongyloidiasis
who were autopsied at the University of Texas Medical Branch (Galveston,
TX). All patients were immunosuppressed and had additional bacterial,
viral, and fungal infections; six patients had received cortisone
therapy and one patient had AIDS. High Strongyloides burdens were noted
in untreated patients or in those with a short period of treatment. The
proximal small intestine and the lungs showed the heaviest parasite
burden, with large numbers of filariform larvae found in both locations.
The lungs showed persistence of larvae in all patients, in the absence
of intestinal or extraintestinal infection; this suggests that the
respiratory cycle may be more resistant to therapy than the intestinal
cycle. In the intestines, filariform larvae were seen at all levels, but
higher burdens were seen in the upper as compared to lower small
intestine, and larvae were more concentrated in the proximal jejunum
than in the duodenum. Autoinfection (i.e., filariform larval
penetration) occurred more prominently in the distal small and proximal
large intestine than in the distal colon. Most filariform larvae were
found in the intestinal lymphatics and were highly concentrated in
mesenteric and retroperitoneal lymph nodes; conversely, larvae were not
found in the spleen and were found in very low density in the liver.
These findings, in concert, suggest that during autoinfection in humans,
the Stronglyloides larvae transverse lymphatics to the thoracic duct,
then pursue a lymphohematogenous dissemination to the lungs where they
penetrate the air spaces and ascend through the airways to reach the
gut.
DE Aged Aged, 80 and over Animal AIDS-Related Opportunistic
Infections/PATHOLOGY Body Burden Female Human Intestinal Diseases,
Parasitic/PATHOLOGY/PARASITOLOGY Liver Diseases,
Parasitic/PATHOLOGY/PARASITOLOGY Lung Diseases,
Parasitic/PATHOLOGY/PARASITOLOGY Male Middle Age Opportunistic
Infections Strongyloides/ISOLATION & PURIF/PHYSIOLOGY
Strongyloidiasis/*PATHOLOGY/PARASITOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).