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Strongyloidiasis in patients with hematologic malignancies

M Nucci1, R Portugal, W Pulcheri

  • 1Hematology Service, University Hospital, Federal University of Rio de Janeiro Medical School, Brazil.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 1, 1995
PubMed
Summary

Strongyloidiasis is common in Brazilian patients with hematologic malignancies, often presenting with fever and eosinophilia. Predictive factors include schistosomiasis, ascariasis, and steroid use, with disseminated disease being rare.

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Area of Science:

  • Infectious Diseases
  • Tropical Medicine
  • Clinical Epidemiology

Background:

  • Strongyloidiasis is a parasitic infection with a wide spectrum of clinical manifestations.
  • Its prevalence and associated risk factors in specific patient populations require further investigation.

Purpose of the Study:

  • To identify clinical characteristics and risk factors for strongyloidiasis in patients treated between 1979 and 1992.
  • To assess the occurrence of disseminated strongyloidiasis in this cohort.

Main Methods:

  • Retrospective study of 343 patients, with 53 diagnosed with strongyloidiasis and compared to 200 controls.
  • Analysis included patient demographics, underlying diseases, corticosteroid use, and clinical symptoms.
  • Multiple logistic regression was used to determine predictive factors.

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Main Results:

  • Patients with strongyloidiasis showed a higher incidence of eosinophilia (P = .01) and fever (P = .03).
  • Predictive factors for strongyloidiasis included schistosomiasis (OR, 6.58), ascariasis (OR, 2.78), and corticosteroid use (OR, 2.29).
  • A single fatal case of disseminated strongyloidiasis was observed (1.9%).

Conclusions:

  • Strongyloidiasis is highly prevalent among patients with hematologic malignancies in Brazil.
  • Eosinophilia and fever are significant clinical indicators.
  • Disseminated disease appears to be an infrequent complication.