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Update on Strongyloidiasis in the Immunocompromised Host

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Abstract

Immunocompromised persons are the most vulnerable population at risk for developing life-threatening clinical syndromes associated with strongyloidiasis, such as hyperinfection syndrome (HS) or dissemination. This review focuses on describing Strongyloides infection in the immunocompromised host, including immune response against this infection, analyzing the cases with HS published during the past 4 years in the United States, and describing the most sensitive diagnostic tools and the most effective treatment for each clinical syndrome. Strongyloidiasis is becoming an important parasitic disease in the United States, especially in the immunocompromised immigrant population. Because the transplant population is particularly at risk for developing HS, both recipients and donors should be screened for Strongyloides. Clinicians should also be aware that the development of HS can follow unexpectedly a few days after appropriate anthelminthic therapy. Highly sensitive screening tests are still not available in the major tertiary medical centers. Parenteral ivermectin has been used in some severe cases. Further therapy developments and improving diagnostic tools are warranted.

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Acknowledgments

We would like to acknowledge the outstanding work of the staff including Dr. Raul Tello, Marco Canales, Carmen Quijano, and Matilde Quijano at the Laboratory Parasitology, Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

Disclosure

Conflicts of interest: L. Marcos—none; A. Terashima—none; M. Canales —none; E. Gotuzzo—grant support from Merck.

Author information

Authors and Affiliations

  1. Infectious Diseases Division, Internal Medicine Department, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110, USA

    Luis A. Marcos

  2. Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru

    Luis A. Marcos, Angélica Terashima, Marco Canales & Eduardo Gotuzzo

  3. PO. Box 4314, Lima, 100, Peru

    Angélica Terashima, Marco Canales & Eduardo Gotuzzo

Authors
  1. Luis A. Marcos
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  2. Angélica Terashima
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  3. Marco Canales
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  4. Eduardo Gotuzzo
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Correspondence to Luis A. Marcos.

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Marcos, L.A., Terashima, A., Canales, M. et al. Update on Strongyloidiasis in the Immunocompromised Host. Curr Infect Dis Rep 13, 35–46 (2011). https://doi.org/10.1007/s11908-010-0150-z

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  • DOI: https://doi.org/10.1007/s11908-010-0150-z

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