Strongyloides stercoralis infection in a Spanish regional hospital: Not just an imported disease

Abstract

Introduction: Strongyloides stercoralis infection is more prevalent in tropical regions but autochthonous cases have been reported in Spain, mainly in La Safor (Valencia). The objective is to describe the strongyloidiasis cases registered in a regional hospital of Alicante province (Spain) and to determine if they were autochthonous cases.

Methods: Retrospective study of all diagnosed cases of strongyloidiasis in Vega Baja Hospital (Orihuela, Alicante) between January 1999 and March 2016.

Results: A total of 10 cases were found, four of which were autochthonous cases. Two of them presented with a hyper-infection syndrome, with a fatal outcome. All autochthonous cases were in patients ≥69years old with gastrointestinal, cutaneous, and/or respiratory symptoms. Serology was positive in the 8 cases studied. Larvae were found in histopathological samples of the gastrointestinal tract of three patients.

Conclusions: We communicate the first autochthonous cases of strongyloidiasis in the region of Vega Baja. Screening programs should be implemented, especially in immunosuppressed patients or patients under chronic corticosteroid treatment.

Keywords: Autochthonous case; Caso autóctono; Cribado; Enfermedad importada; Epidemiology; Epidemiología; Hyper-infection syndrome; Imported disease; Screening; Strongyloides stercoralis; Síndrome de hiperinfestación.