[Disseminated strongyloidiasis, a rare cause of multiple organ failure]

Strongyloidiasis is an parasitic intestinal disease, frequent in tropical countries and fairly rare in temperate areas under certain conditions. Disseminated forms can provoke multivisceral damage.

A 75 year-old woman, hospitalized for occlusion, developed multivisceral (cerebral, renal, cardiac pulmonary and hepatic) damage over 48 hours, attributed to strongyloidiasis. The diagnosis was confirmed by isolation of larvae in the tracheal and gastric aspiration fluids. Treatment combined ivermectin and albendazole.

Disseminated stronglyloidiasis is essentially observed in immunodepressed patients, under corticosteroids or HTLV1 carriers, although an HIV status does not appear to intervene. Larvae can be found in all the organs. Death occurs by multivisceral failure in 50 to 70% of cases. Broncho-alveolar washing and examination of the gastric fluids is the key to diagnosis. Treatment relies on thiabendazole, ivermectin or albendazole, and the symptomatic management of all the visceral deficiencies.