Abstract
Systemic strongyloidiasis is a rare but serious complication of intestinal strongyloidiasis. The condition occurs mainly in immunosuppressed patients and has a significant mortality rate. A case of systemic strongyloidiasis is described in a patient who received systemic steroid treatment, and a short review of the literature is given. The increased use of immunosuppressive and cytotoxic treatment necessitates increased awareness of this infection. HIV-infection, however, does not appear to increase the risk of developing systemic strongyloidiasis. Patients from endemic areas and travellers to such areas, even in the remote past, should be examined for strongyloidiasis before being given immunosuppressive treatment. Awareness of the possibility of systemic strongyloidiasis is essential if such a patient develops gastrointestinal or pulmonary symptoms or has repeated episodes of unexplained gram-negative infections while undergoing immunosuppressive treatment.
Similar content being viewed by others
References
Normand LA Sur la maladie dite diarrhee de Cochin-Chine. Comptes Rendus Hebdomadaires des Seances de L'Academie des Sciences 1876, 83: 316–318.
Genta RM, Walzer PD Strongyloidiasis. In: Walzer PD, Genta RM (ed): Parasitic infections in the compromised host. Marcel Dekker, New York, 1989, p. 463–525.
Cook GC Strongyloides stercoralis hyperinfection syndrome: how often is it missed? Quarterly Journal of Medicine 1987, 244: 625–629.
Longworth DL, Weller PF Hyperinfection syndrome with strongyloidiasis. In: Remington JS, Schwartz MN (ed): Current clinical topics in infectious diseases. McGraw-Hill, New York, 1986, p. 1–26.
Genta RM Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease. Reviews of Infectious Diseases 1989, 11: 755–767.
Igra-Siegman Y, Kapila R, Sen P, Kaminski ZC, Louria DB Syndrome of hyperinfection withStrongyloides stercoralis. Reviews of Infectious Diseases 1981, 3: 397–407.
Genta RM Strongyloides stercoralis: immunobiological considerations on an unusual worm. Parasitology Today 1986, 2: 241–246.
Genta RM Immunobiology of strongyloidiasis. Tropical and Geographical Medicine 1984, 36: 223–229.
Neva FA Biology and immunology of human strongyloidiasis. Journal of Infectious Diseases 1986, 153: 397–406.
Genta RM Strongyloidiasis in immunodiagnosis of parasitic diseases. In: Walls KW, Schantz PM (ed): Helminthic diseases. Volume 1. Academic Press, Orlando, 1986, p. 183–199.
Scowden EB, Schaffner W, Stone WJ Overwhelming strongyloidiasis. An unappreciated opportunistic infection. Medicine 1978, 57: 527–544.
Shiwaku K, Chigusa Y, Kadosaka T, Kaneko K Factors influencing development of free-living generations ofStrongyloides stercoralis. Parasitology 1988, 97: 129–138.
Genta RM, Schad GA, Hellman ME Strongyloides stercoralis: parasitological, immunological and pathological observations in immunosuppressed dogs. Transactions of the Royal Society of Tropical Medicine and Hygiene 1986, 80: 34–41.
Harper JS, Genta RM, Gam AA, London WI, Neva FA Experimental disseminated strongyloidiasis inErythrocebus patas. I:Pathology. American Journal of Tropical Medicine and Hygiene 1984, 33: 431–443.
Kimmelstiel F, Lange M Fatal systemic strongyloidiasis following corticosteroid therapy. New York State Journal of Medicine 1984, 84: 399–401.
McNeely DJ, Inouye T, Tam PYW, Ripley SD Acute respiratory failure due to strongyloidiasis in polymyositis. Journal of Rheumatology 1980, 7: 745–750.
Chu E, Whitlock WL, Dietrich RA Pulmonary hyperinfection syndrome withStrongyloides stercoralis. Chest 1990, 97: 1475–1477.
Sarubbi FA Hyperinfection withStrongyloides during treatment of pemphigus vulgaris. Archives of Dermatology 1987, 123: 864–865.
Kebede D Strongyloidiasis and glucocorticoids: case report. Virginia Medical 1986, 113: 104–105.
Yee A, Boylen CT, Noguchi T, Klatt EC, Sharma OP FatalStrongyloides stercoralis infection in a patient receiving corticosteroids. Western Journal of Medicine 1987, 146: 363–364.
De Vault Jr GA, King JW, Rohr MS, Laudreneau MD, Brown III ST, McDonald JC Opportunistic infections withStrongyloides stercoralis in renal transplantation. Reviews of Infectious Diseases 1990, 12: 653–671.
Morgan JS, Schaffner W, Stone WJ Opportunistic strongyloidiasis in renal transplant recipients. Transplantation 1986, 42: 518–524.
Schad GA Cyclosporin may eliminate the threat of overwhelming strongyloidiasis in immunosuppressed patients. Journal of Infectious Diseases 1986, 153: 178.
Genta RM, Lillibridge JP Prominence of IgG4 antibodies in the human responses toStrongyloides stercoralis infection. Journal of Infectious Diseases 1989, 160: 692–699.
Petithory JC, Derouin F AIDS and strongyloidiasis in Africa. Lancet 1987, i: 921.
Gompels MM, Todd J, Peters BS, Main J, Pinching AJ Disseminated strongyloidiasis in AIDS: uncommon but important. AIDS 1991, 5: 329–332.
Newton RC, Limpuangthip P, Greenberg S, Gam A, Neva FA Strongyloides stercoralis hyperinfection in a carrier of HTLV-1 virus with evidence of selective immunosuppression. American Journal of Medicine 1992, 92: 202–208.
Grove DI, Dawkins HJS Effects of prednisolone on murine strongyloidiasis. Parasitology 1981, 83: 401–409.
Genta RM, Ottesen EA, Neva FA, Walzer PD, Tanowitz HB, Wittner M Cellular responses in human strongyloidiasis. American Journal of Tropical Medicine and Hygiene 1983, 32: 990–994.
Genta RM, Harper JS, Gam A, London WI, Neva FA Experimental disseminated strongyloidiasis inErythrocebus patas. II: Immunology. American Journal of Tropical Medicine and Hygiene 1984, 33: 444–450.
Genta RM, Douce RW, Walzer PD Diagnostic implications of parasite-specific immune responses in immunocompromised patients with strongyloidiasis. Journal of Clinical Microbiology 1986, 23: 1099–1103.
Genta RM, Frei DF, Linke MJ Demonstration and partial characterization of parasite-specific immunoglobulin A responses in human strongyloidiasis. Journal of Clinical Microbiology 1987, 25: 1505–1510.
Genta RM, Ottesen EA, Poindexter R, Gam AA, Neva FA, Tanowitz HB, Wittner M Specific allergic sensitization toStrongyloides antigens in human strongyloidiasis. Laboratory Investigation 1983, 48: 633–638.
Schindzielorz A, Edberg SC, Bia FJ Strongyloides stercoralis hyperinfection and central nervous system involvement in a patient with relapsing polychondritis. Southern Medical Journal 1991, 84: 1055–1057.
Boken DJ, Leoni PA, Preheim LC Treatment ofStrongyloides stercoralis hyperinfection syndrome with thiabendazole administered per rectum. Clinical Infectious Diseases 1993, 16: 123–126.
Grove DI Treatment of strongyloidiasis with thiabendazole: an analysis of toxicity and effectiveness. Transactions of the Royal Society of Tropical Medicine and Hygiene 1982, 76: 114–118.
Rossignol JF, Maisonneuve H Albendazole: placebo-controlled study in 870 patients with intestinal helminthiasis. Transactions of the Royal Society of Tropical Medicine and Hygiene 1983, 77: 707–711.
Naquira C, Jimenez G, Guerra JG, Bernal R, Nalin DR, Neu D, Aziz M Ivermectin for human strongyloidiasis and other intestinal helminths. American Journal of Tropical Medicine and Hygiene 1989, 40: 304–309.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hagelskjær, L.H. A fatal case of systemic strongyloidiasis and review of the literature. Eur. J. Clin. Microbiol. Infect. Dis. 13, 1069–1074 (1994). https://doi.org/10.1007/BF02111831
Issue Date:
DOI: https://doi.org/10.1007/BF02111831