Strongyloides Hyper-Infection Syndrome and Ciliocytophthoria Mimicking Balantidium coli
  • Moni Roy
    Department of Internal Medicine, University of Illinois College of Medicine at Peoria and OSF Saint Francis Medical Center, Peoria, IL, USA http://orcid.org/0000-0002-8206-3405
  • Sharjeel Ahmad
    Section of Infectious Diseases, Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria,IL, USA
  • Arif Sarwari
    WVU School of Medicine, Department of Infectious Diseases, Morgantown, WV, USA

Keywords

Strongyloidiasis, hyperinfection syndrome, ciliocytophthoria

Abstract

Ciliocytophthoria is a phenomenon where degenerated cells in infections or malignancy can present as ciliated cells on microscopy and so may be confused with ciliated parasitic infection. We present an interesting case of recurrent shortness of breath, misdiagnosed as chronic obstructive pulmonary disease exacerbations leading to unnecessary exposure to antimicrobials and steroids. The case was diagnosed as Strongyloides hyper-infection syndrome. Another finding worth mentioning was that ciliated cells noted on broncho-alveolar lavage were thought to be a co-infection with Balantidium coli but were later confirmed as ciliocytophthoria.

VIEW THE ENTIRE ARTICLE

References

  • Walzer PD, Milder JE, Banwell JG, Kilgore G, Klein M, Parker R. Epidemiologic features of Strongyloides stercoralis infection in endemic areas of the United States. Am J Trop Med Hyg1982;31:313–319.
  • Seet RCS, Lau LG, Tambyah PA. Strongyloides hyperinfection and hypogammaglobulinemia. Clin Diagn Lab Immunol 2005;12:680–682.
  • Grabowska-Joachimiak A. The morphology of ciliated cells in nasal mucosa during a viral infection. Otolaryngol Pol 1998;52:175–180.
  • Sasaki Y, Abe H, Tokunaga E, Tsuzuki T, Fujioka T. Ciliocytophthoria (CCP) in nasopharyngeal smear from patients with acute tonsillitis. Acta Otolaryngol Suppl 1988;454:175–177.
  • Papanicolaou GN. Degenerative changes in ciliated cells exfoliating from the bronchial epithelium as a cytologic criterion in the diagnosis of diseases of the lung. NY State J Med 1956;56:2647–2650.
  • Martínez-Giron R, Doganci L, Ribas A. From the 19th century to the 21st, an old dilemma: ciliocytophthoria, multiflagellated protozoa, or both? Diagn Cytopathol 2008;36:609–611.
  • Hollander DH, Gupta PK. Detached ciliary tufts in cervico-vaginal smears. Acta Cytol 1974;18:367–369.
  • Mahoney CA, Sherwood N, Yap EH, Singleton TP, Whitney DJ, Cornbleet PJ. Ciliated cell remnants in peritoneal dialysis ?uid. Arch Pathol Lab Med 1993;117:211–213.
  • Hadziyannis E, Yen-Lieberman B, Hall G, Procop GW. Ciliocytophthoria in clinical virology. Arch Pathol Lab Med 2000;124:1220–1223.
  • Wang Y, Tang Z, Ji S, Zhang Z, Chen J, Cheng Z, et al. Pulmonary Lophomonas blattarum infection in patients with kidney allograft transplantation. Transplant Int 2006;19:1006–1013.
  • Views: 537
    HTML downloads: 160
    PDF downloads: 249


    Published: 2021-07-23
    Issue: 2021: Vol 8 No 7 (view)


    How to cite:
    1.
    Roy M, Ahmad S, Sarwari A. Strongyloides Hyper-Infection Syndrome and Ciliocytophthoria Mimicking Balantidium coli. EJCRIM 2021;8 doi:10.12890/2021_002707.

    Most read articles by the same author(s)