Case Reports
Strongyloides stercoralis as an Unusual Cause of COPD Exacerbation
María del Mar Ortiz Romeroa,
, María Dolores León Martínezb, María de los Ángeles Muñoz Pérezb, Antonio Altuna Cuestaa, Alfredo Cano Sánchezb, José Hernández Martínezc
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mmar.ortiz2@carm.es
Correspondence: Dr M.M. Ortiz Romero Sección de Microbiología, Hospital General Reina Sofía Avda. Intendente Jorge Palacios, 1 30003 Murcia, Spain
Correspondence: Dr M.M. Ortiz Romero Sección de Microbiología, Hospital General Reina Sofía Avda. Intendente Jorge Palacios, 1 30003 Murcia, Spain
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"etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital General Reina Sofía, Murcia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Sección de Neumología, Hospital General Reina Sofía, Murcia, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr M.M. Ortiz Romero Sección de Microbiología, Hospital General Reina Sofía Avda. Intendente Jorge Palacios, 1 30003 Murcia, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-05-31" "fechaAceptado" => "2007-06-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155366" "palabras" => array:4 [ 0 => "Strongyloides stercoralis" 1 => "COPD" 2 => "Enteric bacteria" 3 => "Exacerbation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155365" "palabras" => array:4 [ 0 => "Strongyloides stercoralis" 1 => "EPOC" 2 => "Bacterias entéricas" 3 => "Exacerbación" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The nematode of the genus <span class="elsevierStyleItalic">Strongyloides</span> can persist in the body for long periods with asymptomatic eosinophilia as its only manifestation. If patients with chronic obstructive pulmonary disease (COPD) are also infected by this organism, altered cellular immunity or therapy with corticosteroids, which are commonly used to treat COPD exacerbations, could lead to hyperinfection and dissemination of the larvae from the gastrointestinal tract to the bloodstream. Thus, the unexpected presence of enteric bacteria in the context of a nonsevere COPD exacerbation with unexplained chronic eosinophilia should lead us to search for rhabditiform larvae in stool.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Strongyloides</span> es un nematodo que puede persistir en el organismo durante largos períodos y tener como única manifestación eosinofilia asintomática. La enfermedad pulmonar obstructiva crónica (EPOC) puede ser una afección asociada a esta infección. La presencia de una alteración en la inmunidad celular o el uso de esteroides, frecuentes en el tratamiento de la exacerbación de la EPOC, podría provocar una hiperinfección de la larva, arrastrando en su paso al torrente sanguíneo bacterias entéricas. Así pues, la presencia no esperada de bacterias entéricas en la exacerbación de un caso de EPOC no grave con eosinofilia crónica sin filiar debería orientarnos a la búsqueda activa de larvas rabditiformes en las heces.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Strongyloidiasis and other intestinal nematode infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "LX Liu" 1 => "PF Séller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Infect Dis Clin North Am" "fecha" => "1993" "volumen" => "7" "paginaInicial" => "655" "paginaFinal" => "682" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8254165" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "RM Genta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Infec Dis" "fecha" => "1989" "volumen" => "11" "paginaInicial" => "755" "paginaFinal" => "767" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and epidemiologic features of strongyloidiasis. A prospective study in rural Tennessee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "SL Berk" 1 => "A Verghese" 2 => "S Álvarez" 3 => "K Hall" 4 => "B Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "1987" "volumen" => "147" "paginaInicial" => "1257" "paginaFinal" => "1261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3606282" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary hyperinfection syndrome with <span class="elsevierStyleItalic">Strongyloides stercoralis</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "CE Whitlock" 1 => "RA Dietric" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1990" "volumen" => "97" "paginaInicial" => "1475" "paginaFinal" => "1477" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2347234" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Strongyloides stercoralis</span> in the immunocompromised population" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "PB Keiser" 1 => "TB Nutman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Rev" "fecha" => "2004" "volumen" => "17" "paginaInicial" => "208" "paginaFinal" => "217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14726461" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary strongyloidiasis: clinical and imaging features" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "JH Woodring" 1 => "H Halfhill" 2 => "JC Reed" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/ajr.162.3.8109492" "Revista" => array:6 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "1994" "volumen" => "162" "paginaInicial" => "537" "paginaFinal" => "542" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8109492" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis of <span class="elsevierStyleItalic">Strongyloides stercoralis</span> infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "AA Siddiqui" 1 => "SL Berk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Infec Dis" "fecha" => "2001" "volumen" => "33" "paginaInicial" => "1040" "paginaFinal" => "1047" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parasitic pulmonary eosinophilia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "RK Chitkara" 1 => "G Krishna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2006-939520" "Revista" => array:6 [ "tituloSerie" => "Semin Respir Crit Care Med" "fecha" => "2006" "volumen" => "27" "paginaInicial" => "171" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16612768" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improved diagnosis of <span class="elsevierStyleItalic">Strongyloides stercoralis</span> by seven consecutive stool specimens" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "PB Nielsen" 1 => "M Mojon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Zentralbl Bakteriol Mikrobiol Hyg [A]" "fecha" => "1987" "volumen" => "263" "paginaInicial" => "616" "paginaFinal" => "618" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Strongyloides stercoralis</span> infestation associated with septicemia due to intestinal transmural migration of bacteria" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "UC Ghoshal" 1 => "U Ghoshal" 2 => "M Jain" 3 => "A Kumar" 4 => "R Aggarwal" 5 => "A Misra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Gatroenterol Hepatol" "fecha" => "2002" "volumen" => "17" "paginaInicial" => "1331" "paginaFinal" => "1333" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parasitic central nervous system infections in immunocompromised hosts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M Walker" 1 => "JR Zunt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Infec Dis" "fecha" => "2005" "volumen" => "40" "paginaInicial" => "1005" "paginaFinal" => "1015" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Strongyloides</span> hyperinfection presenting as acute respiratory failure and gram-negative sepsis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "AM Newberry" 1 => "DN Williams" 2 => "WN Stauffer" 3 => "DR Boulware" 4 => "BR HendelPaterson" 5 => "PF Walker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.128.5.3681" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2005" "volumen" => "128" "paginaInicial" => "3681" "paginaFinal" => "3684" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16304332" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary manifestations of strongyloidiasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "JH Wehner" 1 => "CM Kirsch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Semin Respir Infect" "fecha" => "1997" "volumen" => "12" "paginaInicial" => "122" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9195677" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infective exacerbations of chronic bronchitis: relation between bacteriologic etiology and lung function" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J Eller" 1 => "A Ede" 2 => "T Schaberg" 3 => "MS Niederman" 4 => "H Mauch" 5 => "H Lode" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1998" "volumen" => "113" "paginaInicial" => "1542" "paginaFinal" => "1548" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9631791" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento antimicrobiano de la enfermedad pulmonar obstructiva crónica en el anciano" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A Torres Martí" 1 => "JA Quintano Jiménez" 2 => "M Martínez Ortiz de Zárate" 3 => "C Rodríguez Pascual" 4 => "J Prieto" 5 => "R Zalacain" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2006" "volumen" => "42" "numero" => "Suppl 3" "paginaInicial" => "1" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16426515" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary strongyloidiasis. Diagnosis by sputum gram stain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B Smith" 1 => "A Verghese" 2 => "C Gutiérrez" 3 => "W Dralle" 4 => "SL Bek" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Am J Med" "fecha" => "1985" "volumen" => "79" "paginaInicial" => "663" "paginaFinal" => "666" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2414988" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0212656711000540" "estado" => "S300" "issn" => "02126567" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000004400000008/v1_201305150357/S1579212908600798/v1_201305150357/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004400000008/v1_201305150357/S1579212908600798/v1_201305150357/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212908600798?idApp=UINPBA00003Z" ]
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| 2024 February | 21 | 19 | 40 |
| 2023 March | 3 | 5 | 8 |
| 2023 February | 18 | 18 | 36 |
| 2023 January | 17 | 38 | 55 |
| 2022 December | 28 | 33 | 61 |
| 2022 November | 29 | 25 | 54 |
| 2022 October | 20 | 33 | 53 |
| 2022 September | 18 | 23 | 41 |
| 2022 August | 28 | 35 | 63 |
| 2022 July | 17 | 49 | 66 |
| 2022 June | 16 | 41 | 57 |
| 2022 May | 28 | 36 | 64 |
| 2022 April | 19 | 31 | 50 |
| 2022 March | 20 | 37 | 57 |
| 2022 February | 15 | 42 | 57 |
| 2022 January | 21 | 36 | 57 |
| 2021 December | 20 | 51 | 71 |
| 2021 November | 16 | 43 | 59 |
| 2021 October | 19 | 62 | 81 |
| 2021 September | 17 | 65 | 82 |
| 2021 August | 11 | 30 | 41 |
| 2021 July | 16 | 30 | 46 |
| 2021 June | 25 | 38 | 63 |
| 2021 May | 19 | 35 | 54 |
| 2021 April | 52 | 119 | 171 |
| 2021 March | 40 | 26 | 66 |
| 2021 February | 18 | 25 | 43 |
| 2021 January | 16 | 16 | 32 |
| 2020 December | 17 | 25 | 42 |
| 2020 November | 14 | 13 | 27 |
| 2020 October | 15 | 11 | 26 |
| 2020 September | 7 | 7 | 14 |
| 2020 August | 13 | 13 | 26 |
| 2020 July | 19 | 22 | 41 |
| 2020 June | 12 | 7 | 19 |
| 2020 May | 14 | 16 | 30 |
| 2020 April | 16 | 21 | 37 |
| 2020 March | 12 | 8 | 20 |
| 2020 February | 16 | 28 | 44 |
| 2020 January | 22 | 25 | 47 |
| 2019 December | 19 | 14 | 33 |
| 2019 November | 29 | 31 | 60 |
| 2019 October | 5 | 17 | 22 |
| 2019 September | 6 | 24 | 30 |
| 2019 August | 14 | 24 | 38 |
| 2019 July | 12 | 18 | 30 |
| 2019 June | 7 | 19 | 26 |
| 2019 May | 14 | 23 | 37 |
| 2019 April | 50 | 44 | 94 |
| 2019 March | 21 | 18 | 39 |
| 2019 February | 19 | 28 | 47 |
| 2019 January | 9 | 23 | 32 |
| 2018 December | 18 | 31 | 49 |
| 2018 November | 27 | 25 | 52 |
| 2018 October | 19 | 11 | 30 |
| 2018 September | 18 | 12 | 30 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 14 | 9 | 23 |
| 2018 March | 5 | 5 | 10 |
| 2018 February | 6 | 4 | 10 |
| 2018 January | 9 | 16 | 25 |
| 2017 December | 10 | 5 | 15 |
| 2017 November | 6 | 6 | 12 |
| 2017 October | 10 | 11 | 21 |
| 2017 September | 4 | 5 | 9 |
| 2017 August | 6 | 14 | 20 |
| 2017 July | 10 | 15 | 25 |
| 2017 June | 7 | 10 | 17 |
| 2017 May | 6 | 8 | 14 |
| 2017 April | 2 | 3 | 5 |
| 2017 March | 6 | 27 | 33 |
| 2017 February | 7 | 7 | 14 |
| 2017 January | 1 | 3 | 4 |
| 2016 December | 6 | 8 | 14 |
| 2016 November | 11 | 10 | 21 |
| 2016 October | 17 | 14 | 31 |
| 2016 September | 10 | 10 | 20 |
| 2016 August | 10 | 5 | 15 |
| 2016 July | 14 | 6 | 20 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 84 | 9 | 93 |
| 2015 September | 74 | 14 | 88 |
| 2015 August | 81 | 10 | 91 |
| 2015 July | 87 | 11 | 98 |
| 2015 June | 61 | 9 | 70 |
| 2015 May | 115 | 7 | 122 |
| 2015 April | 64 | 8 | 72 |
| 2015 March | 74 | 7 | 81 |
| 2015 February | 83 | 7 | 90 |
| 2015 January | 71 | 9 | 80 |
| 2014 December | 58 | 26 | 84 |
| 2014 November | 67 | 15 | 82 |
| 2014 October | 72 | 11 | 83 |
| 2014 September | 61 | 9 | 70 |
| 2014 August | 59 | 17 | 76 |
| 2014 July | 49 | 13 | 62 |
| 2014 June | 97 | 9 | 106 |
| 2014 May | 94 | 16 | 110 |
| 2014 April | 87 | 10 | 97 |
| 2014 March | 92 | 14 | 106 |
| 2014 February | 86 | 16 | 102 |
| 2014 January | 79 | 11 | 90 |
| 2013 December | 62 | 11 | 73 |
| 2013 November | 52 | 7 | 59 |
| 2013 October | 63 | 9 | 72 |
| 2013 September | 52 | 10 | 62 |
| 2013 August | 55 | 12 | 67 |
| 2013 July | 74 | 11 | 85 |
| 2013 June | 54 | 13 | 67 |
| 2013 May | 56 | 8 | 64 |
| 2013 April | 39 | 8 | 47 |
| 2013 March | 12 | 3 | 15 |
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