Strongyloides stercoralis: a cause of morbidity and mortality for indigenous people in Central Australia

Abstract

Complicated strongyloidiasis occurs in association with HTLV-1 infection in central Australia. This finding has significant implications for the management of S. stercoralis in the region.

Human T-lymphotropic virus-1 serology in the Northern Territory: 2008–2011

“…These results are significant, as since 1993 there has been increasing recognition that HTLV-1 infection is associated with morbidity from other diseases. 3,5,17 Indeterminate serology profiles may represent true positives, false positives or patients seroconverting. 18 The 18.1% indeterminate rate noted with the Abbott Architect HTLV-1/2 screening assay, which is based on specific purified proteins and peptides, may relate to two factors.…”

“…[2][3][4][5] However, there have been relatively few case reports of HTLV-1 associated myelopathy, or adult T-cell leukaemia/lymphoma, the most well-known sequelae of HTLV-1 infection documented in this population. 6,7 Accordingly, the role of HTLV-1 infection within the Central Australian population has remained largely under-appreciated.…”

Strongyloides hyperinfection syndrome presenting as enterococcal meningitis in a low-endemicity area

“…12 In a recent series of 38 cases of serious bacterial infections associated with strongyloidiasis, 55% had meningitis and 73% had bacteremia. 6 The most prevalent causes were enteric gramnegative bacteria. Enterococci only rarely have been associated with HS.…”

“…Enterococci only rarely have been associated with HS. 6,13 Enterococcal meningitis accounts for only 0.3-4% of all cases of bacterial meningitis.…”

“…5 Several studies have shown that lack of suspicion of strongyloidiasis in low-endemicity areas may result in delayed diagnosis and high mortality. 6,7 Screening of high-risk patients (i.e., those with history of travel to endemic areas) for infection with strongyloides before receiving immunosuppressive therapy has been proposed. Nevertheless, our patient did not report recent or past travelling to endemic areas.…”