Atypical Presentation of Small Lymphocytic Lymphoma with Pericardial Effusion

Patient: Female, 61

Final Diagnosis: Pericardial effusion secondary to CLL

Symptoms: Shortness of breath

Medication: —

Clinical Procedure: —

Specialty: Oncology

Venovenous Extracorporeal Membrane Oxygenation in a Gravid Patient with Acute Respiratory Distress Syndrome: A Case Report

Patient: Female, 22

Final Diagnosis: Acute respiratory distress syndrome

Symptoms: Flank pain • urinary frequency

Medication: —

Clinical Procedure: ECMO

Specialty: Critical Care Medicine

The Worm that Clogs the Lungs: Strongyloides Hyper-Infection Leading to Fatal Acute Respiratory Distress Syndrome (ARDS)

BACKGROUND Strongyloides stercoralis is an intestinal helminth. Parasitism is caused by penetration of the larvae through the skin. It is endemic in tropical and subtropical regions of the world and in the United States occurs in the southeastern region. It has a tendency to remain dormant or progress to a state of hyper-infection during immunosuppression. CASE REPORT We present the case of a 70-year-old Nigerian who developed fatal ARDS secondary to Strongyloides infection after been treated with steroids for treatment of autoimmune necrotizing myopathy. Despite adequate management with mechanical ventilation and appropriate antifungal therapy, the patient died on day 19 of hospitalization. CONCLUSIONS S. stercoralis is known to affect every organ in the body. ARDS is often an overlooked complication of Strongyloides hyper-infection, which is often deadly. Immediate diagnosis and treatment are important for patient survival.