Clinical study
Fatal strongyloidiasis in immunosuppressed patients

https://doi.org/10.1016/0002-9343(74)90481-1Get rights and content

Abstract

Cell-mediated immunity is a major bulwark of defense against certain viruses, intracellular bacteria, fungi and protozoa. Cellmediated immunity against helminthic infections is inadequately understood. Thirty-two patients with strongyloidiasis who were studied at autopsy had underlying diseases characterized by depressed cell-mediated immunity, including lepromatous leprosy, malignant tumors, protein-calorie malnutrition, burn, radiation, advanced tuberculosis, tertiary syphilis or pancytopenia. At autopsy defective cell-mediated immunity against strongyloides was manifested by a lack of a granulomatous immune response to larvae in the tissues. Depletion of lymphocytes in thymus glands and in the thymus-dependent areas of lymph nodes and spleens in the hosts indicated in inadequate capacity of cell-mediated immunity for preventing Strongyloides stercoralis.

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    The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. This investigation was supported in part by a research contract, Project No. 3A061102B71Q, from the Medical Research and Development Command, United States Army, Washington, D.C., and by the American Leprosy Missions, Inc., New York, N.Y.

    1

    From the Infectious Diseases Branch and the Geographic Pathology Division, Armed Forces Institute of Pathology, Washington, D.C.

    Present address: Department of Pathology, University of Massachusetts Medical School, 419 Belmont Street, Worcester, Massachusetts 01604.

    2

    Kivuvu Leprosarium, Institut Medical Evanglique, Kimpese via Kinshasa, Republic of Zaire.

    Present address: Department of Pathology, University of Hawaii Medical School, Honolulu, Hawaii.

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