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).