A rare cause of asthma exacerbation: systemic strongyloides

Strongyloides is an helmintic infection that may induce bronchospasm during systemic migration of larvae. We report a case of a 60 years old man origi nating from Caribbean who had corticodependent asthma since 30 years. He wa s hospitalised for severe exacerbation that worsen when steroid dosage was increase. Sputum examination revealed the presence in great number of Larva e of Strongyloides stercoralis. A good clinical evolution was achieved afte r specific antihelmintic treatment. Later on, it was even possible to stop completely steroid treatment. This clinical case demonstrates the interest to look for Strongyloides superinfection in asthmatic patients that worsen when receiving increasing dose of steroids. This is particularly important for patients who have resided, even many years earlier; in areas where inte stinal helmintic infection are endemic.