Fatal relapse of disseminated strongyloidiasis in an HIV-positive patient, despite ivermectin treatment

Mattioni, S.; Valin, Nadia; Cracco, Christophe; Thellier, Marc; Danis, M.; Caumes, Éric

doi:10.1179/136485908x337616

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…Seven HIV patients were also receiving steroids for suspected Pneumocystis jiroveci pneumonia [24,26], immune reconstitution inflammatory syndrome [105], misdiagnosis of asthma [58], Wegener granulomatosis [36], toxoplasmosis encephalitis [36], cerebral TB with vasculitis [124]; six of them died.…”

Section: Resultsmentioning

confidence: 99%

Severe strongyloidiasis: a systematic review of case reports

et al. 2013

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BackgroundStrongyloidiasis is commonly a clinically unapparent, chronic infection, but immuno suppressed subjects can develop fatal disease. We carried out a review of literature on hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), in order to describe the most challenging aspects of severe strongyloidiasis.MethodsWe conducted a structured search using PubMed to collect case reports and short case series on HS/DS published from 1991 to 2011. We restricted search to papers in English, Spanish, Italian and French. Case reports were classified as HS/DS according to given definitions.ResultsRecords screened were 821, and 311 were excluded through titles and abstract evaluation. Of 510 full-text articles assessed for eligibility, 213 were included in qualitative analysis. As some of them were short case series, eventually the number of cases analyzed was 244.Steroids represented the main trigger predisposing to HS and DS (67% cases): they were mostly administered to treat underlying conditions (e.g. lymphomas, rheumatic diseases). However, sometimes steroids were empirically prescribed to treat signs and symptoms caused by unsuspected/unrecognized strongyloidiasis. Diagnosis was obtained by microscopy examination in 100% cases, while serology was done in a few cases (6.5%). Only in 3/29 cases of solid organ/bone marrow transplantation there is mention of pre-transplant serological screening. Therapeutic regimens were different in terms of drugs selection and combination, administration route and duration. Similar fatality rate was observed between patients with DS (68.5%) and HS (60%).ConclusionsProper screening (which must include serology) is mandatory in high - risk patients, for instance candidates to immunosuppressive medications, currently or previously living in endemic countries. In some cases, presumptive treatment might be justified. Ivermectin is the gold standard for treatment, although the optimal dosage is not clearly defined in case of HS/DS.

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Section: Resultsmentioning

confidence: 99%

Severe strongyloidiasis: a systematic review of case reports

et al. 2013

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Les formes graves de strongyloïdose

Develoux

2014

Journal des Anti-infectieux

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Severe strongyloidiasis: a systematic review and meta-analysis of 339 cases

Rojas

Montoya

Villanueva-Lozano

et al. 2023

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Strongyloidiasis is a parasitosis representing a significant public health problem in tropical countries. It is often asymptomatic in immunocompetent individuals but its mortality rate increases to approximately 87% in severe forms of the disease. We conducted a systematic review, including case reports and case series, of Strongyloides hyperinfection and dissemination from 1998 to 2020 searching PubMed, EBSCO and SciELO. Cases that met the inclusion criteria of the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist were analysed. Statistical analysis was performed using Fisher’s exact test and Student's t-test and a Bonferroni correction for all the significant values. A total of 339 cases were included in this review. The mortality rate was 44.83%. The presence of infectious complications, septic shock and a lack of treatment were risk factors for a fatal outcome. Eosinophilia and ivermectin treatment were associated with an improved outcome.

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Fatal relapse of disseminated strongyloidiasis in an HIV-positive patient, despite ivermectin treatment

Cited by 4 publications

References 23 publications

Severe strongyloidiasis: a systematic review of case reports

Severe strongyloidiasis: a systematic review of case reports

Les formes graves de strongyloïdose

Severe strongyloidiasis: a systematic review and meta-analysis of 339 cases

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