Diagnosis of Latent Strongyloidiasis Following Corticosteroid Therapy in a Patient with COVID-19 Infection

Strongyloidiasis, classified as a neglected tropical disease (NTD), is predominantly prevalent in tropical and subtropical regions, impacting an estimated 100-370 million individuals globally. The northern and southern provinces of Iran are recognized as endemic areas for this disease, characterized by environmental conditions such as optimal temperature and humidity conducive to the survival of the causative agent. Although this disease commonly presents no symptoms, individuals with compromised immune systems or those undergoing corticosteroid treatment face an elevated risk of developing hyper_infection syndrome, a serious complication with potentially fatal outcomes. In the case of immunocompromised patients, especially those receiving corticosteroid therapy, the timely diagnosis of strongyloidiasis is imperative, as the infection can lead to life-threatening outcomes. The present study reports a case of latent strongyloidiasis diagnosis using a serological method. A 68-year-old female patient, originally from Guilan Province, residing in Tehran Province, with a medical history of asthma spanning over a decade, was admitted to the hospital and prescribed corticosteroid treatment for severe acute respiratory syndrome caused by the novel coronavirus (SARS-CoV-2). The patient exhibited symptoms including shortness of breath, constipation, skin itching and abdominal bloating. Following a referral to the Diagnostic Laboratory of Strongyloidiasis at the School of Public Health, Tehran University of Medical Sciences, the patient was found to be positive for Strongyloides stercoralis using an enzyme-linked immunosorbent assay (ELISA) kit (Novalisa, NovaTec, Germany). The infection was successfully treated with anthelmintic drugs. It is imperative to consider strongyloidiasis in patients with a history of residing in endemic areas or immigration, and testing should be conducted before the initiation of immunosuppressive therapy. The ELISA method is a rapid and effective diagnostic tool for detecting S. stercoralis in suspected patients, particularly prior to corticosteroid treatment.