Immune reconstitution syndrome to Strongyloides stercoralis infection

Taylor, Clare L; Subbarao, Vani; Gayed, Sedki; Ustianowski, Andrew

doi:10.1097/qad.0b013e3280117f94

Cited by 27 publications

(12 citation statements)

References 9 publications

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“…Strongyloides stercoralis infection was diagnosed by coproscopy on direct faecal smear and/or via the Baermann method [18]. Any recovered L1s were identified according to morphological keys [19].…”

Section: Methodsmentioning

confidence: 99%

Occurrence of strongyloidiasis in privately owned and sheltered dogs: clinical presentation and treatment outcome

et al. 2017

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BackgroundThe increasing number of reports of human infections by Strongyloides stercoralis from a range of European countries over the last 20 years has spurred the interest of the scientific community towards this parasite and, in particular, towards the role that infections of canine hosts may play in the epidemiology of human disease. Data on the epidemiology of canine strongyloidiasis is currently limited, most likely because of the inherent limitations of current diagnostic methods.MethodsFaecal samples were collected directly from the rectal ampulla of 272 animals of varying age and both genders living in Apulia, southern Italy. Dogs included were either privately owned (n = 210), living in an urban area but with unrestricted outdoor access (Group 1), or shelter dogs (n = 62 out of ~400) hosted in a single shelter in the province of Bari in which a history of diarrhoea, weight loss, reduced appetite and respiratory symptoms had been reported (Group 2). Strongyloides stercoralis infection was diagnosed by coproscopy on direct faecal smear and via the Baermann method.ResultsSix of 272 dogs were positive for S. stercoralis at the Baermann examination; all but one were from the shelter (Group 2) and displayed gastrointestinal clinical signs. The only owned dog (Group 1) infected with S. stercoralis, but clinically healthy, had been adopted from a shelter 1 year prior to sampling. Five infected dogs were treated with fenbendazole (Panacur®, Intervet, Animal Health, 50 mg/kg, PO daily for 5 days), or with a combination of fenbendazole and moxidectin plus imidacloprid spot-on (Im/Mox; Advocate® spot-on, Bayer). Post-treatment clearance of infection was confirmed in three dogs by Baermann examination, whereas treatment failure was documented in two dogs by Baermann and/or post-mortem detection of adult parasites.ConclusionsThis study describes, for the first time, the presence of S. stercoralis infection in sheltered dogs from southern Italy. Data indicate that S. stercoralis infection may pose a concern for sheltered animals and raise questions on potential risks of infection for staff of municipal shelters in southern European countries. Given that a single course of treatment with fenbendazole, associated or not with Im/Mox spot-on, may not eliminate the infection, effective treatment protocols should be investigated and control strategies targeting the environment considered for reducing the risk of zoonotic infection.

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Section: Methodsmentioning

confidence: 99%

Occurrence of strongyloidiasis in privately owned and sheltered dogs: clinical presentation and treatment outcome

et al. 2017

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“…Another two cases of disseminated strongyloidiasis were reported in patients with Escherichia coli bacteraemia, eosinophilia and pneumonitis153 and E. coli meningitis154. The fourth case was described in a patient with s0 trongyloides enteritis with thrombocytopenia155. IRIS-associated terminal ileitis caused by Cryptosporidium spp., the first case report of intestinal protozoan infection, was described in a patient with abdominal symptoms of watery, bloodless diarrhoea and epigastric pain156.…”

Section: Immune Reconstitution Inflammatory Syndrome (Iris) Associatementioning

confidence: 99%

Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

Nissapatorn¹,

Sawangjaroen²

2011

Indian J Med Res

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After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan parasites and pose a public health problem in acquired immunodeficiency syndrome (AIDS) patients. These are the only two enteric protozoan parasites that remain in the case definition of AIDS till today. Leismaniasis, strongyloidiasis and toxoplasmosis are the three main opportunistic causes of systemic involvements reported in HIV-infected patients. Of these, toxoplasmosis is the most important parasitic infection associated with the central nervous system. Due to its complexity in nature, toxoplasmosis is the only parasitic disease capable of not only causing focal but also disseminated forms and it has been included in AIDS-defining illnesses (ADI) ever since. With the introduction of highly active anti-retroviral therapy (HAART), cryptosporidiosis, leishmaniasis, schistosomiasis, strongyloidiasis, and toxoplasmosis are among parasitic diseases reported in association with immune reconstitution inflammatory syndrome (IRIS). This review addresses various aspects of parasitic infections in term of clinical, diagnostic and therapeutic challenges associated with HIV-infection.

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“…Long-term consequences include schistosomiasis-associated portal hypertension, cardiac and gastrointestinal abnormalities from Chagas disease, and disseminated strongyloidiasis in the setting of human T-cell lymphotropic virus (HTLV) co-infection [12]–[14]. In addition, HIV-infected patients can have more severe and protean sequelae such as immune reconstitution syndromes from schistosomiasis and strongyloidiasis, rare but potentially fatal strongyloides hyperinfection, and more rapid development of hepatic fibrosis from schistosomiasis [6], [15]–[18]. Chagas disease reactivation in HIV-infected persons can be lethal with manifestations including meningo-encephalitis and acute myocarditis [19]–[21].…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Persistent Parasitic Infections in Foreign-Born, HIV-Infected Persons in the United States

et al. 2011

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BackgroundForeign-born, HIV-infected persons are at risk for sub-clinical parasitic infections acquired in their countries of origin. The long-term consequences of co-infections can be severe, yet few data exist on parasitic infection prevalence in this population.Methodology/Principal FindingsThis cross-sectional study evaluated 128 foreign-born persons at one HIV clinic. We performed stool studies and serologic testing for strongyloidiasis, schistosomiasis, filarial infection, and Chagas disease based on the patient's country of birth. Eosinophilia and symptoms were examined as predictors of helminthic infection. Of the 128 participants, 86 (67%) were male, and the median age was 40 years; 70 were Mexican/Latin American, 40 African, and 18 from other countries or regions. Strongyloides stercoralis antibodies were detected in 33/128 (26%) individuals. Of the 52 persons from schistosomiasis-endemic countries, 15 (29%) had antibodies to schistosome antigens; 7 (47%) had antibodies to S. haematobium, 5 (33%) to S. mansoni, and 3 (20%) to both species. Stool ova and parasite studies detected helminths in 5/85 (6%) persons. None of the patients tested had evidence of Chagas disease (n = 77) or filarial infection (n = 52). Eosinophilia >400 cells/mm3 was associated with a positive schistosome antibody test (OR 4.5, 95% CI 1.1–19.0). The only symptom significantly associated with strongyloidiasis was weight loss (OR 3.1, 95% CI 1.4–7.2).Conclusions/SignificanceGiven the high prevalence of certain helminths and the potential lack of suggestive symptoms and signs, selected screening for strongyloidiasis and schistosomiasis or use of empiric antiparasitic therapy may be appropriate among foreign-born, HIV-infected patients. Identifying and treating helminth infections could prevent long-term complications.

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Immune reconstitution syndrome to Strongyloides stercoralis infection

Cited by 27 publications

References 9 publications

Occurrence of strongyloidiasis in privately owned and sheltered dogs: clinical presentation and treatment outcome

Occurrence of strongyloidiasis in privately owned and sheltered dogs: clinical presentation and treatment outcome

Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

High Prevalence of Persistent Parasitic Infections in Foreign-Born, HIV-Infected Persons in the United States

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