Hyperinfective strongyloidiasis in the medical ward: review of 27 cases in 5 years

Abstract

Background: Hyperinfective strongyloidiasis is rare, but the mortality rate is very high. It occurs most commonly in immunocompromised patients. We reviewed the clinical presentation and mortality rate of cases managed in our facility.

Method: Twenty-seven patients with hyperinfective strongyloidiasis admitted to our medical ward over a 5-year period were prospectively studied.

Results: In our study, there were 18 males and 9 females (mean age, 58 years). Weight loss, gastrointestinal symptoms, hypoproteinemia, and anemia were the main clinical presentations. Mortality rate was 26%; human T-lymphotropic virus (HTLV-1) infection, chronic alcoholism, eosinopenia, sepsis, and prerenal azotemia on admission were poor prognostic factors. HTLV-1 infection was the main underlying disease in 71% of patients, and 44% of patients had a history of chronic alcoholism.

Conclusion: Early diagnosis and treatment with thiabendazole may reduce mortality in hyperinfective strongyloidiasis. Hyperinfective strongyloidiasis may also be a clinical marker of HTLV-1 infection in areas where both entities are endemic or in immigrants from such areas.