Determinants of reactivation of inapparent Strongyloides stercoralis infection in patients hospitalized for unrelated admitting diagnosis

Abstract

We have identified immunosuppressive therapy, viral infection-associated immunodeficiency, alcoholism, and diabetes mellitus as risk factors for reactivation of chronic inapparent strongyloidiasis. Analysis of hemogram data suggests the low sensitivity of hypereosinophilia to be a marker for this helminthiasis.

A Rare Case of Strongyloides stercoralis Hyperinfection in a Diabetic Patient from Romania—Case Report and Review of the Literature

“…The results are presented in Table 1. A few cases were excluded due to the high probability of bias on account of unclear or missing data regarding immunosuppression or the diagnosis of severe strongyloidiasis: local corticosteroid injections [57], multiple myeloma in remission and corticosteroid treatment after hospital admission [58], possible untreated rheumatoid arthritis and short corticosteroid treatment after hospital admission [59], unclear corticoid treatment for asthma and emphysema [60], unclear asthma treatment [61], previous single-dose corticoid treatment [62], previously undiagnosed diabetes and short corticoid treatment after hospital admission [63], possible corticosteroid treatment and partial gastrectomy surgery [64], unclear severe strongyloidiasis diagnosis [65,66].…”

Unrecognized Strongyloides stercoralis Infection in Hemodialysis Patient With Recurrent Diarrhea and Readmissions

“…Healthy individuals are usually asymptomatic even if chronically infected. A number of conditions are known to predispose an individual to autoinfection or hyper infection including immunosuppressive therapy (glucocorticoids, chemotherapy), HIV/HTLV coinfection, malignancy, solid organ or bone marrow transplantation, diabetes mellitus, hypogammaglobulinemia and severe malnutrition (1). The diagnosis of strongyloidiasis is suspected in patients presented with gastrointestinal symptoms, maculopapular rash and with or without eosinophilia.…”

“…An estimated 30 -100 million people worldwide are infected with S. stercoralis (1). Although most infected individuals are asymptomatic, the chronic infection reactivates and manifests as life-threatening multisystem disease in immunocompromized patients (2).…”