Strongyloides stercoralis hyperinfection in a patient with AIDS

Strongyloides stercoralis is a prevalent cause of severe infection and death in many areas of the world where fecal contamination of soil or water is common. The nematode is endemic in tropical and subtropical regions of the world, including northeastern Argentina, where infection rates may exceed 30% of the population. Strongyloides infections are often light and associated with few or no signs and symptoms, particularly during initial migration through the body. However, certain persons are at risk of severe, clinically significant disease developing. The manifestations of hyperinfection syndrome are divided, based on the system of origin, into intestinal and extraintestinal disease mainly involving the respiratory tract. Unfortunately, S stercoralis hyperinfection is seldom diagnosed until late in the course of the disease, which contributes to a high death rate. In patients with the hyperinfection syndrome and massive Strongyloides infection, adult respiratory distress syndrome with pulmonary insufficiency that requires intubation and mechanical ventilation may also develop. We report a case of S stercoralis hyperinfection in an HIV-infected patient, which resulted in death.