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Current Infectious Disease Reports

, Volume 13, Issue 1, pp 35–46 | Cite as

Update on Strongyloidiasis in the Immunocompromised Host

  • Luis A. Marcos
  • Angélica Terashima
  • Marco Canales
  • Eduardo Gotuzzo
Article

Abstract

Immunocompromised persons are the most vulnerable population at risk for developing life-threatening clinical syndromes associated with strongyloidiasis, such as hyperinfection syndrome (HS) or dissemination. This review focuses on describing Strongyloides infection in the immunocompromised host, including immune response against this infection, analyzing the cases with HS published during the past 4 years in the United States, and describing the most sensitive diagnostic tools and the most effective treatment for each clinical syndrome. Strongyloidiasis is becoming an important parasitic disease in the United States, especially in the immunocompromised immigrant population. Because the transplant population is particularly at risk for developing HS, both recipients and donors should be screened for Strongyloides. Clinicians should also be aware that the development of HS can follow unexpectedly a few days after appropriate anthelminthic therapy. Highly sensitive screening tests are still not available in the major tertiary medical centers. Parenteral ivermectin has been used in some severe cases. Further therapy developments and improving diagnostic tools are warranted.

Keywords

Strongyloides stercoralis Strongyloidiasis Immunocompromised host Hyperinfection syndrome Dissemination Autoinfection Transplant population Immigrant Agar plate Anthelminthic Ivermectin Parenteral USA 

Notes

Acknowledgments

We would like to acknowledge the outstanding work of the staff including Dr. Raul Tello, Marco Canales, Carmen Quijano, and Matilde Quijano at the Laboratory Parasitology, Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

Disclosure

Conflicts of interest: L. Marcos—none; A. Terashima—none; M. Canales —none; E. Gotuzzo—grant support from Merck.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Luis A. Marcos
    • 1
    • 2
  • Angélica Terashima
    • 2
    • 3
  • Marco Canales
    • 2
    • 3
  • Eduardo Gotuzzo
    • 2
    • 3
  1. 1.Infectious Diseases Division, Internal Medicine DepartmentWashington University School of MedicineSt. LouisUSA
  2. 2.Institute of Tropical Medicine Alexander von HumboldtUniversidad Peruana Cayetano HerediaLimaPeru
  3. 3.LimaPeru

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