Thread by @guerreroespejo

A 32-YO♀️ from Guatemala, Ph+ B-ALL post #chemotherapy: #dyspnea
CT: ground-glass opacities (2A yellow box), interstitial pulmonary edema with septal thickening (2B yellow circles), & pericardial effusion (2C yellow arrows), lymph nodes (2D yellow arrows)
Eosinophilia
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Due to normal ejection fraction, the differential diagnosis of dyspnea included non-cardiogenic pulmonary edema, pneumonitis secondary to chemotoxicity, and infection.
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doi.org/10.1016/j.idcr…
#haematology #radiology #IDtwitter

She progressed to acute hypoxic respiratory failure.

🔬bronchoalveolar lavage: numerous larvae (3A,3B) with short buccal grove (arrow head) and prominent genital primordium (arrow) consistent with STRONGYLOIDES HYPERINFECTION

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#lungdisease #parasitology #Pathologists

Hyperinfection syndrome can occur from autoinfection leading to massive & disseminated life-threatening parasitic infection
While multiple organs can be affected in hyperinfection syndrome, most presentations involve the lungs & gastrointestinal tract
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#microbiology #medicine

The reactivation of the infection process was most likely secondary to her chemotherapy treatment.

Strongyloides hyperinfection diagnosis entails a high level of suspicion.
Cytology evaluation is an essential factor for diagnosis.
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#parasites #pathology #pathTwitter

Strongyloides stercoralis is a soil-transmitted helminth endemic to tropical and subtropical regions and can be acquired due to parasite penetration through the skin.
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#MedTwitter #Doctor #MedStudentTwitter

Strongyloides stercoralis can remain dormant in the gastrointestinal system for decades after the primary infection.

In immunocompromised patients, this parasite can cause autoinfection with progression to hyperinfection syndrome.
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#resident #MedicalStudents #MedEd