Investigation of Strongyloidiasis Transmission from Infected Mother to Newborn Postpartum: A Case Report

Strongyloidiasis is a disease caused by the soil-transmitted nematode Strongyloides stercoralis. It is considered a neglected disease that can lead to long-term disability, growth retardation in children, complications during pregnancy, and adverse effects on the fetus. In the present case report, we examined a case of strongyloidiasis in a newborn born to a mother with confirmed strongyloidiasis during pregnancy, diagnosed by serological, parasitological, and molecular methods. A 38-year-old woman at 35 weeks of gestation from a rural area in Rasht, Guilan Province, Iran, presented with gastrointestinal symptoms (diarrhea, abdominal pain) and severe dyspnea since the fourth month of pregnancy. Her medical history included hypothyroidism and a pituitary microadenoma. Laboratory findings revealed a peripheral blood eosinophil count of 2%. Stool examination (direct smear, formalin-ethyl acetate concentration, and agar plate culture) and serological testing (ELISA for S. stercoralis antibodies) confirmed strongyloidiasis, further validated by molecular methods. Due to potential risks of anti-helminthic drugs during pregnancy, treatment was deferred until one month post-delivery, after breastfeeding cessation. The newborn's stool and breast milk were tested parasitologically and molecularly one month after birth, with negative results, indicating no infection. Although mother-to-fetus transmission has not been definitively established, the fetus is considered a high-risk group. Pregnant women, due to their immunocompromised state, are also classified as a high-risk population and may develop disseminated strongyloidiasis or hyperinfection syndrome. Given the adverse effects of antiparasitic treatment during pregnancy, routine serological screening for S. stercoralis in women before pregnancy in endemic areas is recommended to enable early intervention and mitigate complications, safeguarding maternal and fetal health.