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Experimental Infection of Mice with the Parasitic Nematode Strongyloides ratti
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Update on strongyloidiasis in the immunocompromised host.

Luis A Marcos1, Angélica Terashima, Marco Canales

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

Current Infectious Disease Reports
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Strongyloidiasis poses a severe risk to immunocompromised individuals, potentially causing life-threatening hyperinfection syndrome (HS). Early screening and effective treatments are crucial for managing this parasitic infection in vulnerable populations.

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Area of Science:

  • Medical Parasitology
  • Immunology
  • Infectious Diseases

Background:

  • Strongyloidiasis is a parasitic infection that disproportionately affects immunocompromised individuals.
  • Life-threatening complications like hyperinfection syndrome (HS) and dissemination are significant concerns in this population.
  • The incidence of Strongyloides infection is increasing in the United States, particularly among immunocompromised immigrants.

Purpose of the Study:

  • To review Strongyloides infection in immunocompromised hosts.
  • To analyze recent cases of HS in the US.
  • To discuss diagnostic tools and treatment strategies for strongyloidiasis.

Main Methods:

  • Literature review focusing on immunocompromised hosts with Strongyloides.
  • Analysis of published HS cases in the US over the last four years.
  • Evaluation of diagnostic sensitivity and treatment efficacy.

Main Results:

  • Immunocompromised individuals are highly susceptible to severe Strongyloides outcomes.
  • The transplant population requires specific screening protocols for Strongyloides.
  • Hyperinfection syndrome can occur unexpectedly even after treatment.
  • Current diagnostic tests lack sufficient sensitivity in major medical centers.
  • Parenteral ivermectin shows promise in severe cases.

Conclusions:

  • Strongyloidiasis is a growing concern in the US, especially for immunocompromised immigrants and transplant recipients.
  • Screening of transplant donors and recipients for Strongyloides is recommended.
  • Development of more sensitive diagnostic tools and advanced therapies is urgently needed.