Hyperinfection withStrongyloides stercoralis

Abstract

SummaryStrongyloidiasis is caused by Strongyloides stercoralis, which commonly produces gastrointestinal problems. If immune systems are compromised, the nematode larvae may spread and produce Strongyloides hyperinfection. Diagnosis of strongyloidiasis is based on the observation of larvae in coproparasitological studies. We present a case of a 49-year-oldman, VIH, who developed Strongyloides hyperinfection, diagnosed postmortem. Our patient reached the dissemination stage, which resulted in severe damage to the stomach and intestine, perforation of the intestinal wall, as well as sepsis due to the dissemination of bacteria. The diagnosis is difficult because of the low larvae excretion in stools. It is usually performed by the microscopic examination of fresh and fixed enriched stool samples. Serology was reported to be useful for screening and follow-up after treatment. This case reaffirms that HIV immunosuppression favours the dissemination of S stercoralis larvae. Thus, a search for intestinal parasites should be considered in similar cases. BACKGROUND

<i>Strongyloides stercoralis</i> in an immunocompetent adult: An unexpected cause of weight lost

“…In this patient there was no eosinophilia, but it is present in 50% to 80% of patients with mild infection. In contrast, a low eosinophil count occurs in patients with hyperinfection and disseminated disease [20,30], as seems to be the present case.…”

Selected aspects of helminth infections Schistosoma sp., Ascaris lumbricoides, Strongyloides stercoralis in individuals diagnosed with human immunodeficiency virus (HIV) infection

“…Wyniki niektórych badań wskazują, że skutkiem HAART, oprócz zmniejszenia poziomu wiremii HIV, jest spadek poziomu przeciwciał IgE. Stanowi to przesłankę, że HIV jest jednym z czynników aktywujących wytwarzanie IgE (39,60,72,73,74).…”

“…The results of some studies revealed that, apart from a decrease in HIV viraemia levels, the HAART therapy causes a decrease in IgE antibody levels. This leads to a conclusion that HIV is one of the factors that promote IgE production (39,60,72,73,74).…”

A case of fatal gastrointestinal haemorrhage due to hyperinfection with Strongyloides stercoralis

“…The hyperinfection syndrome represents acceleration of the normal lifecycle of S. stercoralis, leading to excessive worm burden in the traditional passage route, even as, disseminated strongyloidiasis involves widespread dissemination outside the gut and lungs, involving the liver, brain, heart, and urinary tract Romero-Cabello et al (2012).…”