Hyperinfection syndrome should be considered a potential medical emergency. Thus, treatment should be started immediately if this is being considered. Strongyloides stercoralis Hyperinfection remain quiescent indefinitely, immunosuppression can lead to the hyperinfection syndrome, which is. Whereas in chronic strongyloidiasis and in hyperinfection syndrome the larvae are limited to the GI tract and the lungs, in disseminated.

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In humans, IgE antibodies are specifically formed against filariform larvae [ 97 ]. Relapses, especially involving gastrointestinal tract, were noted even after treatment of strongyloidiasis.

The hyperinfection syndrome happens from the enormous multiplication and migration of infective larvae especially in an immunosuppressed state.

Predisposing risks for dissemination are delineated, and the roles played for newer diagnostics in the identification of at-risk individuals are detailed. Subsequent impaired host immunity leads to accelerated autoinfection and an overwhelming number of migrating larvae. The cytology from the BAL also did not reveal any malignant cells. This helminth resides in the small intestine of the human host. The safety of ivermectin in children who weigh less than 15kg has not been demonstrated.

Intestinal mast cell response and mucosal defence against Strongyloides venezuelensis in interleukinhyporesponsive mice. Thus, treatment should be started immediately if this is being considered. Involvement of the central nervous system may lead to headache, altered mental state, seizures and rarely coma [ 1 ].

He attended our Centre on D59 with similar symptoms. Allogeneic transplantation for lymphoma: Disseminated strongyloidiasis in nephrotic syndrome. In fact, the most common complaint noted was abdominal bloating [ 1718 ].


Eosinophils and neutrophils contribute to larval killing during the primary immune response, and neutrophils are effector cells in the secondary response to S stercoralis. Corticosteroid use is commonly associated with hyperinfection syndrome. Even though strongyloid-specific antibodies are noted in the infection, they do not provide the required immunity without the help of other defense mechanisms. Ivermectin is excreted in low concentrations in human milk.

Strongyloidiasis should be routinely investigated in patients with chronic kidney disease who will undergo immunosuppressive therapy. The most important laboratory finding seen in patients with strongyloidiasis is eosinophilia [ 65 ]. Conditions associated with hyperinfection syndrome are as follows: His course in hospital was complicated by an episode of confusion.

A Fatal Strongyloides Stercoralis Hyperinfection Syndrome in a Patient With Chronic kidney Disease

Latest Most Read Most Cited Comparison of clinical tools for dengue diagnosis in a pediatric population-based cohort. Furthermore, it can be difficult to distinguish between active cases and historical cases as traditional antibodies can persist for some time. Presentations resembling inflammatory bowel disease, specifically ulcerative colitis, are rare.

Detection of Strongyloides stercoralis in the cerebrospinal fluid of a patient with acquired immunodeficiency syndrome. Authors’ contributions RSV carried the literature review, drafted the manuscript, and prepared the tables and figures. Utility of multiple-stool-specimen ova and parasite examinations in a high-prevalence setting. These worms reproduce sexually and produce rhabditiform larvae in turn, which then molt into filariform larvae.

Syhdrome at — The rest of the examination was essentially benign. Recommend on Facebook Tweet Share Compartir. This article has been cited by other articles in PMC.


Successful ivermectin treatment of hepatic strongyloidiasis presenting with severe eosinophilia.

Disseminated infection occurs when larvae migrate away from the lung and gastrointestinal tract into other organ systems [ 17 ]. B Computed tomography of the chest on day 4 of admission.

Either studies in animals have revealed adverse effects on the fetus teratogenic or embryocidal, or other and there are no controlled studies in women or studies in women and animals are not available.

Strongyloides stercoralis Hyperinfection Syndrome and Disseminated Disease

Physicians should be particularly diligent to consider Strongyloides in patients:. Repeated multiple stool specimens should be analyzed to increase the efficacy of the test in the presence of strong suspicion of strongyloidiasis [ 2873 ]. Add comment Close comment form modal. Subacute intestinal obstruction can also be caused by strongyloidiasis [ 38 ]. Strongyloides stercoralis under the microscope. Multiple case reports indicate a potential increase in the frequency of fatal hyperinfection or disseminated infection with corticosteroid therapy in patients with asymptomatic or mild strongyloidiasis [ 752 – 56 ].

Inhibition of Th2 cell-mediated, humoral or mucosal immunity is associated with HS. Moreover, there is a decrease in the efficacy of treatment of S. Author information Article notes Copyright and License information Disclaimer.