A possible need for routine screening for Strongyloides stercoralis infection in Indian haemophilia patients

Strongyloides stercoralis has a unique free-living stage in addition to the parasitic life cycle causing dissemination and hyperinfection syndrome. Clinical manifestations ranges from asymptomatic presentation in the immunocompetent host to disseminated disease and even septic shock in immunocompromised host. The non-specific presentation, risk factors, and complications of strongyloidiasis often require multiple tests for screening and diagnosis to increase the sensitivity of the tests. Here, we present a case report of a newly diagnosed patient of HIV with overlapping symptoms of respiratory and gastrointestinal tract involvement who was treated successfully. This emphasizes the need for strong clinical suspicion and screening of patients with the risk factors of strongyloidiasis.

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Strongyloidiasis in a newly diagnosed patient living with HIV – A case report

Shivekar

Sri

Sugumaran

et al. 2023

GJHSR

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Seroprevalence of Strongyloides infection among steroid recipients in a tertiary care centre in North India

et al. 2022

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Background: Strongyloides stercoralis (S. stercoralis), a unique parasite, can cause mortal disease even years after the exposure. Iatrogenic use of steroids can complicate asymptomatic infections to a life-threatening hyperinfection and/ or disseminated infection. Data regarding seroprevalence of strongyloidiasis remains scarce and this knowledge gap needs due attention in many endemic countries including India. Aim: The present study is aimed at assessing the seroprevalence of Strongyloides infection and the need for routine screening among individuals receiving steroid therapy. Methodology: Eighty patients receiving steroid therapy and thirty healthy volunteers who had not received any immunosuppressive drugs and/or anthelminthic therapy in last six months were enrolled as cases and controls respectively and they were screened by Strongyloides IgG ELISA.Results: Among the 80 patients on steroids, the mean cumulative prednisolone equivalent dose received was 8.2 g (±11.2 g) for a mean duration of 184 days, 16 patients (20%, 95% CI 11.9-30) had a positive Strongyloides IgG serology. Only 4 controls (4/30, 13.3%, CI 3.8-30.7) tested positive (p=0.4). Conclusions: Our study demonstrated a Strongyloides seroprevalence of 20% in the study population emphasizing the need for screening for Strongyloides infection prior to immunosuppressive therapy in order to prevent hyperinfection or possible dissemination.

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A possible need for routine screening for Strongyloides stercoralis infection in Indian haemophilia patients

Cited by 2 publications

References 11 publications

Strongyloidiasis in a newly diagnosed patient living with HIV – A case report

Strongyloidiasis in a newly diagnosed patient living with HIV – A case report

Seroprevalence of Strongyloides infection among steroid recipients in a tertiary care centre in North India

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