Screening, prevention, and treatment for hyperinfection syndrome
and disseminated infections caused by Strongyloidesstercoralis.
Strongyloides stercoralis assumes a special status due to its versatile life cycle (Autoinfection) and its potential to cause long-lasting infections, particularly in immunosuppressed individuals with a defective cellmediated immunity, in whom it may lead to hyperinfection syndrome
and disseminated strongyloidiasis involving several organs.
In immunocompromised individuals, larvae can massively invade the gastrointestinal and pulmonary systems (hyperinfection syndrome
) and other organs (disseminated strongyloidiasis).
Its presentation can vary from asymptomatic eosinophilia in immunocompetent patients to hyperinfection syndrome
causing multiple organ failure in immunocompromised patients.
Pulmonary strongyloidiasis is a common manifestation of strongyloides hyperinfection syndrome
, and the detection of increased number of larva in sputum is the hallmark of hyperinfection as seen with the case reported here.
(2,4) The hyperinfection syndrome
causes overwhelming infection in immunocompromised hosts as the parasite begins to replicate without leaving its host, through an accelerated autoinfection cycle.
Immunosuppressed patients with chronic strongyloidiasis are at high risk of developing serious complications, such as hyperinfection syndrome
and the dissemination of the parasite to several organs, causing sepsis and even death.
Severe life-threatening complications of hyperinfection syndrome
and disseminated strongyloidiasis may develop in patients with HTLV-1 confection or in patients receiving immunosuppressive therapy, such as corticosteroids [1-3].
(5) Literature describes SS infection as chronic and asymptomatic, but a change in immune status can lead to an increase in parasite load, hyperinfection syndrome
, dissemination, and death.
Immunosuppressed persons can develop strongyloides hyperinfection syndrome
, which can be fatal (1).
develops when immunosuppression reduces the immune surveillance and results in augmentation of the normal life cycle of the parasite leading to a dramatic increase in the density of the larvae.
Dx: Strongyloides stercoralis hyperinfection syndrome