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July 1987

Hyperinfection With Strongyloides During Treatment of Pemphigus Vulgaris

Author Affiliations

Department of Internal Medicine Quillen-Dishner College of Medicine Box 21160A Johnson City, TN 37614-0002

Arch Dermatol. 1987;123(7):864-865. doi:10.1001/archderm.1987.01660310028005

To the Editor.—  Infection has been reported as the major cause of death among patients with pemphigus vulgaris.1,2 While staphylococcal pneumonia or septicemia has most often been described as complicating the course of this disease, clinicians should also be aware of certain geographic infectious diseases that, in the presence of immunosuppressive therapy, can develop into life-threatening conditions. Strongyloides stercoralis, an intestinal nematode, is endemic in parts of the southeastern United States where it usually causes an asymptomatic infection or a mild gastrointestinal tract disorder.3 However, serious or fatal illness due to this organism can develop in infected persons who are exposed to immunosuppressive therapy.4 This report describes a North Carolina resident in whom hyperinfection with Strongyloides developed during treatment for pemphigus.

Report of a Case.—  A 61-year-old man with chronic schizophrenia resided in western North Carolina under conditions of poor personal hygiene. In late 1984, mouth ulcers

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