Strongyloides stercoralisin the Immunocompromised Population

Abstract

Strongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. S. stercoralis is unique among intestinal nematodes in its ability to complete its life cycle within the host through an asexual autoinfective cycle, allowing the infection to persist in the host indefinitely. Under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome, characterized by increased numbers of infective filariform larvae in stool and sputum and clinical manifestations of the increased parasite burden and migration, such as gastrointestinal bleeding and respiratory distress. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment and human T-lymphotropic virus type 1 infection are the two conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelmintic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome as well as for primary and secondary prevention of hyperinfection in patients whose exposure history and underlying condition put them at increased risk

Effect of treatment of Strongyloides infection on HTLV‐1 expression in a patient with adult T‐cell leukemia

“…S. stercoralis is an intestinal nematode usually acquired transcutaneously. Adult worms reside in the small bowel and release larvae into the intestinal lumen that are excreted in the stool for years [14]. Autoinfection is normally limited by the host immune system, but immunosuppressed patients can develop disseminated disease (hyperinfection syndrome).…”

Strongyloidiasis – the most neglected of the neglected tropical diseases?

“…26 In contrast, human T cell lymphotropic virus type 1 infection is strongly associated with a higher S. stercoralis prevalence as well as with an increased incidence of hyperinfection. [27][28][29] Although there is a pronounced association between disseminated strongyloidiasis and suppression of the immune system, there are also a significant number of fatal cases in the literature which could not be linked to any known impairment of the immune system. 30 They have tentatively been explained by host factors of intestinal parasite control which act at the interface between the host and the parasite, i.e.…”

Prevalence of Strongyloides stercoralis and other intestinal parasitic infections among mentally retarded residents in central institution of southern Iran

“…It is estimated that over 1 billion people are infected with STH and 30-100 millions with S. stercoralis worldwide [7,[11][12][13][14] . S. stercoralis's unique life cycle makes it possible to survive in human host and causes autoinfection to lead chronic disease which could have remained for several years [13][14][15] .…”

“…It is estimated that over 1 billion people are infected with STH and 30-100 millions with S. stercoralis worldwide [7,[11][12][13][14] . S. stercoralis's unique life cycle makes it possible to survive in human host and causes autoinfection to lead chronic disease which could have remained for several years [13][14][15] . Although most of infections are asymptomatic, disseminated and hyper infection may occur in immunocompromised and immune deficient individuals as a fatal disease [16][17][18][19][20] .…”