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Medline ® Abstract for Reference 22

of 'Strongyloidiasis'

Cutaneous periumbilical purpura in disseminated strongyloidiasis in cancer patients: a pathognomonic feature of potentially lethal disease?
Salluh JI, Bozza FA, Pinto TS, Toscano L, Weller PF, Soares M
Braz J Infect Dis. 2005;9(5):419.
Cutaneous manifestations in disseminated strongyloidiasis are infrequent but should raise the suspicion for its diagnosis. We retrospectively evaluated the charts of six patients with cancer and a proven diagnosis of disseminated strongyloidiasis. All patients had received prophylaxis with albendazole before starting antineoplastic therapy, which included high-dose steroids. They presented with septic shock, acute respiratory failure and characteristic purpuric periumbilical skin lesions. Strongyloides larvae were identified in tracheal aspirates (n=5), gastric aspirates (n=4), lung (n=2) and skin biopsies (n=2). All patients died despite antihelminthic therapy and intensive care support.
Intensive Care Unit, National Institute of Cancer, Praca Cruz Vermelha 23, Rio de Janeiro, RJ, Brazil. jorgesalluh@yahoo.com.br