Immunocompromised group differences in the presentation of intestinal strongyloidiasis

Area of Science:

• Infectious Diseases
• Clinical Medicine
• Parasitology

Background:

• Strongyloides stercoralis is a soil-transmitted helminth causing strongyloidiasis.
• Clinical manifestations of strongyloidiasis can differ based on host immune status.
• Understanding these differences is crucial for accurate diagnosis and management.

Purpose of the Study:

• To retrospectively analyze and compare the clinical presentations of strongyloidiasis.
• To identify distinct symptoms and laboratory findings in different patient groups, including HIV-positive individuals, those with chronic illnesses, immunosuppressant drug users, and healthy subjects.
• To highlight the specific challenges in diagnosing strongyloidiasis in immunocompromised populations.

Main Methods:

• Retrospective analysis of hospital records from 213 outpatients in Bangkok, Thailand.
• Diagnosis of Strongyloides stercoralis infection confirmed by stool inspection.
• Categorization of patients based on immune status: HIV infection, chronic illness, immunosuppressant drug use, and healthy controls.

Main Results:

• HIV patients with strongyloidiasis commonly presented with chronic diarrhea, fever, and persistent coughing, significantly differing from other immunocompromised groups.
• Healthy individuals with strongyloidiasis more frequently experienced acute diarrhea and abdominal pain.
• Peripheral eosinophil blood counts were significantly lower in HIV patients (P=0.004) compared to other groups.
• Males were more prevalent across all categories.
• Patients with chronic illness were significantly older (56.8±13.5 years) than other groups.

Conclusions:

• Strongyloidiasis is frequently observed in geriatric males.
• HIV-positive individuals are identified as a high-risk group for S. stercoralis infection.
• This study provides novel insights into the varied clinical spectrum of intestinal strongyloidiasis across different immunocompromised patient groups.