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Rare disease
Hyperinfection with Strongyloides stercoralis
  1. Raúl Romero-Cabello1,2,
  2. Javier Villagroy Gómez1,
  3. Mercedes Hernández González3,
  4. Raúl Romero Feregrino4
  1. 1Department of Infectology, Hospital General de México, Mexico City, Mexico DF, Mexico
  2. 2Department of Microbiology and Parasitology, UNAM, Mexico city, Mexico, Mexico DF, Mexico
  3. 3Department of Pathology, Hospital General de México, Mexico City, Mexico DF, Mexico
  4. 4Department of Infectology Instituto para el Desarrollo integral de la Salud (IDISA), Mexico City, Mexico DF, Mexico
  1. Correspondence to Dr Raúl Romero Feregrino, drraulromeroferegrino{at}hotmail.com

Summary

Strongyloidiasis is caused by Strongyloides stercoralis, which commonly produces gastrointestinal problems. If immune systems are compromised, the nematode larvae may spread and produce Strongyloides hyperinfection. Diagnosis of strongyloidiasis is based on the observation of larvae in coproparasitological studies. We present a case of a 49-year-oldman, VIH, who developed Strongyloides hyperinfection, diagnosed postmortem. Our patient reached the dissemination stage, which resulted in severe damage to the stomach and intestine, perforation of the intestinal wall, as well as sepsis due to the dissemination of bacteria. The diagnosis is difficult because of the low larvae excretion in stools. It is usually performed by the microscopic examination of fresh and fixed enriched stool samples. Serology was reported to be useful for screening and follow-up after treatment. This case reaffirms that HIV immunosuppression favours the dissemination of S stercoralis larvae. Thus, a search for intestinal parasites should be considered in similar cases.

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