Steroid-induced Strongyloidiasis with Cholestasis Post-COVID-19 Pneumonia

Area of Science:

• Infectious Diseases
• Immunology
• Critical Care Medicine

Background:

• Immunosuppressive agents, particularly steroids, are widely used to manage severe COVID-19 inflammatory responses.
• This widespread use may increase the risk of opportunistic infections, including strongyloidiasis.
• Opportunistic infections pose a significant threat to patients recovering from severe COVID-19.

Observation:

• A middle-aged man, previously healthy and without recent travel, developed cholestasis with strongyloidiasis.
• The patient had received a prolonged course of steroids for severe COVID-19 pneumonia.
• Symptoms emerged three weeks after completing steroid therapy.

Findings:

• Strongyloidiasis was diagnosed in a patient post-immunosuppressive therapy for COVID-19.
• The patient was successfully treated with a combination of albendazole and ivermectin.
• This case highlights a potential complication of COVID-19 treatment.

Implications:

• A high index of suspicion for strongyloidiasis is necessary in patients with symptoms after immunosuppressant therapy for severe COVID-19.
• Screening for strongyloidiasis and empirical ivermectin treatment may be beneficial for high-risk patients, even in non-endemic areas.
• Preventing opportunistic infections is critical for improving outcomes in severe COVID-19 survivors.