CLINICAL AND IMAGING FEATURES OF PULMONARY STRONGYLOIDIASIS

We evaluated 20 patients with pulmonary strongyloidiasis for risk fact ors, clinical and imaging manifestations, complications, treatment, an d outcome. Eighteen (90%) had risk factors for strongyloidiasis includ ing steroid use, age greater than 65, chronic lung disease, use of his tamine blockers, or chronic debilitating illness. Pulmonary signs and symptoms, including cough, shortness of breath, wheezing, and hemoptys is, were present in 19 (95%); adult respiratory distress syndrome (ARD S) developed in 9 (45%). Pulmonary infiltrates occurred in 18 (90%). G astrointestinal signs and symptoms were also common. Peripheral blood eosinophilia occurred in 15 (75%). Twelve (60%) had secondary infectio n, and 3 (15%) had bacterial lung abscesses. All were treated with thi abendazole, 25 mg/kg twice daily; on average, patients without ARDS we re treated for 3 days, versus 7 days for those with ARDS. Seventy perc ent responded to therapy; 30% died. Preexisting chronic lung disease a nd ARDS were statistically significant predictors of a poor prognosis.