[Strongyloidiasis in nephrologic patients].

Area of Science:

• Medical Parasitology
• Infectious Diseases
• Clinical Nephrology

Background:

• Strongyloides stercoralis causes strongyloidiasis, prevalent in tropical/subtropical travelers and immigrants.
• Infection is often asymptomatic but can lead to severe hyperinfection or disseminated disease in immunocompromised patients.
• Diagnosis relies on larval detection in stool; ivermectin is the preferred treatment.

Observation:

• Two cases of Ecuadorian males with Strongyloides stercoralis are presented.
• One patient developed disseminated strongyloidiasis while on corticosteroid therapy and was successfully treated with ivermectin.
• The second patient with IgA nephropathy and kidney issues had chronic strongyloidiasis diagnosed before immunosuppression, preventing dissemination with timely ivermectin treatment.

Findings:

• Early diagnosis and treatment with ivermectin can prevent disseminated Strongyloides stercoralis infection.
• Screening for asymptomatic strongyloidiasis is vital before initiating immunosuppressive therapies like steroids.
• Rising incidence of strongyloidiasis necessitates increased awareness in non-endemic areas due to migration and travel.

Implications:

• Proactive screening for Strongyloides stercoralis in at-risk populations is essential.
• Timely ivermectin administration can avert severe complications and mortality associated with immunosuppression.
• This highlights the importance of considering parasitic infections in patients undergoing immunosuppressive treatment for various conditions.