Respiratory hyperinfection with Strongyloides stercoralis in a patient with renal failure

Abstract

Ivermectin, albendazole and empirical broad-spectrum antibiotics for bacterial superinfection (amoxicillin and clavulanic acid for 5 days followed by piperacillin and tazobactam plus levofloxacin).

Risk factors for acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in south India

“…Although there is literature from India on complicated Strongyloides infection in the form of case reports and case series, [6,7] this is the fi rst study that has attempted to determine the association of Strongyloides with predisposing factors, including HIV, and prospectively tried to identify the development of hyper-and disseminated infection. In conclusion, the study indicates that, in an Indian setting, strongyloidiasis is common in HIVpositive patients with low CD4 counts and may lead to the development of fatal complicated infection.…”

“…It is a fatal complication of hyperinfection syndrome reported to occur in 12-60% of the cases. [5,6] [2] Although there have been many case reports on Strongyloides stercoralis infection in India, [6,7] few studies have identifi ed the predisposing risk factors for acquiring this infection. In the present study, we attempted to identify the predisposing risk factors for strongyloidiasis and the Indian Journal of Medical Microbiology vol.…”

Hyperinfection Syndrome in Strongyloidiasis

“…In some cases, diagnosis is difficult despite a low intestinal worm load and larval excretion in the faeces (Rajapurkar et al, 2007). The classic triad of urticaria, abdominal pain and diarrhoea is suggestive of a diagnosis of strongyloidiasis.…”

“…Albendazole has variable therapeutic efficacy but has been used in hyperinfection syndrome and remains a viable treatment alternative to ivermectin. Mebendazole can be used to treat strongyloidiasis but is not recommended because of an association with liver dysfunction (Rajapurkar et al, 2007). Recently, there has been a change in the treatment of strongyloidiasis, as more studies support the choice of the drug ivermectin, which is effective at killing worms in the intestine.…”

“…Higher mortality rates occur from extraintestinal strongyloidiasis, which in most of these cases are related to corticosteroid therapy to treat rejection (Keiser & Nutman, 2004). Renal transplants are most commonly associated with hyperinfection, which is related to immunosuppressive treatments (Devault et al, 1990;Rajapurkar et al, 2007;Valar et al, 2007). Cases of hyperinfection have been described in transplant recipients of other organs, such as the liver (Vilela et al, 2008;Rodrigues-Hernandez et al, 2009), heart (Schaeffer et al, 2004, pancreas (Ben-Yousseff et al, 2005), lung (Balagopal et al, 2009), and intestine (Patel et al, 2008).…”