Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez P, 2006. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworms. Lancet 367: 1521–1532.
Montes M, Sawhney C, Barros N, 2010. Strongyloides stercoralis: there but not seen. Curr Opin Infect Dis 23: 500–504.
Genta RM, 1995. Strongyloides stercoralis. Blaser MJ, Smith PD, Ravdin JI, Greenberg HB, Guerran RL, eds. Infections of the Gastrointestinal Tract. New York, NY: Raven Press, 1197–1207.
Glinz S, Siue KD, Knopp S, Lohourignon LK, Yao KP, Steinmann P, Rinaldi L, Cringoli G, N’Groan E, Utzinger J, 2010. Comparing diagnostic accuracy of Kato-Katz, Koga agar plate, ether-concentration, and FLOTAC for Schistosoma mansoni and soil-transmitted helminthes. PLoS Negl Trop Dis 4: e754.
Croker C, Reporter R, Redelings M, Mascola L, 2010. Strongyloidiasis-related deaths in the United States, 1991–2006. Am J Trop Med Hyg 83: 422–426.
Dawson-Hahn EE, Greenberg SI, Domachowske JB, Olson BG, 2010. Eosinophilia and the seroprevalence of schistosomiasis and strongyloidiasis in newly arrived pediatric refugees: an examination of Centers for Disease Control and Prevention screening guidelines. J Pediatr 156: 1016–1018.
Gill GV, Welch E, Bailey JW, Bell DR, Beeching NJ, 2004. Chronic Strongyloides stercoralis infection in former British Far East prisoners of war. QJM 97: 789–795.
Puthiyakunnon S, Boddu S, Li Y, Zhou X, Wang C, Li J, Chen X, 2014. Strongyloidiasis—an insight into its global prevalence and management. PLoS Negl Trop Dis 8: e3018.
Viney ME, 1996. Developmental switching in the parasitic nematode Strongyloides ratti. Proc Biol Sci 263: 201–208.
Buonfrate D, Requena-Mendez A, Angheben A, Munoz J, Gobbi F, Van Den Ende J, Bisoffi Z, 2013. Severe strongyloidiasis: a systematic review of case reports. BMC Infect Dis 13: 78.
Olsen A, Van Lieshout L, Marti H, Polderman T, Polman K, Steinman P, Stothard R, Thybo S, Verweij JJ, Magnussen P, 2009. Strongyloidiasis—the most neglected of the tropical diseases? Trans R Soc Trop Med Hyg 103: 967–972.
Sarangarajan R, Ranganathan A, Belmonte AH, Tchertkoff V, 1997. Strongyloides stercoralis infection in AIDS. AIDS Patient Care STDS 11: 407–414.
Ferreira MS, Nishioka Sde A, Borges AS, Costa-Cruz JM, Rossin IR, Rocha A, Silvestre M, Nunes-Araujo F, 1999. Strongyloidiasis and infection due to human immunodeficiency virus: 25 cases at a Brazilian teaching hospital, including seven cases of hyperinfection syndrome. Clin Infect Dis 28: 154–155.
Pukkila-Worley R, Nardi V, Branda JA, 2014. Case 28-2014: a 39-year-old man with a rash, headache, fever, nausea and photophobia. N Engl J Med 371: 1051–1060.
Link K, Orenstein R, 1999. Bacterial complications of strongyloidiasis: Streptococcus bovis meninigitis. South Med J 92: 728–731.
Jain AK, Agarwal SK, el-Sadr W, 1994. Streptococcus bovis bacteremia and meninigitis associated with Strongyloides stercoralis colitis in a patient infected with human immunodeficiency virus. Clin Infect Dis 18: 253–254.
De Silva T, Raychaudhuri M, Poulton M, 2005. HIV infection associated with Strongyloides stercoralis colitis resulting in Streptococcus bovis bacteraemia and meningitis. Sex Transm Infect 81: 276–277.
Linder JD, Monkemuller KE, Lazenby AJ, Wilcox CM, 2000. Streptococcus bovis bacteremia associated with Strongyloides stercoralis colitis. Gastrointest Endosc 52: 796–798.
Keiser PB, Nutman TB, 2004. Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev 17: 208–217.
Centers for Disease Control and Prevention, 2017. Strongyloidiasis. Available at: https://www.cdc.gov/parasites/strongyloides/health_professionals/index.html#tx. Accessed August 17, 2017.
Tanton DD, Durning S, Chambers S, 2002. Pulmonary hyperinfection with Strongyloides stercoralis in an immunocompetent patient. J Gen Intern Med 17: 72–73.
Husni RN, Gordon SM, Longworth DL, Adal KA, 1996. Disseminated Strongyloides stercoralis infection in an immunocompetent patient. Clin Infect Dis 23: 663.
Scowden EB, Schaffner W, Stone WJ, 1978. Overwhelming strongyloidiasis: an unappreciated opportunistic infection. Medicine 57: 527–544.
Schaffel R, Nucci M, Carvalho E, Braga M, Almeida L, Portugal R, Pulcheri W, 2001. The value of an immunoenzymatic test (enzyme-linked immunosorbent assay) for the diagnosis of strongyloidiasis in patients immunosuppressed by hematologic malignancies. Am J Trop Med Hyg 65: 346–350.
Abdalla J, Saad M, Myers JW, Moorman JP, 2005. An elderly man with immunosuppression, shortness of breath and eosinophilia. Clin Infect Dis 40: 1464.
Biggs BA, Caruana S, Mihrshahi S, Jolley D, Leydon J, Chea L, Nuon S, 2009. Management of chronic strongyloidiasis in immigrants and refugees: is serologic testing useful? Am J Trop Med Hyg 80: 788–791.
Kobayashi J, Sato Y, Toma H, Takara M, Shiroma Y, 1994. Application of enzyme immunoassay for postchemotherapy evaluation of human strongyloidiasis. Diagn Microbiol Infect Dis 18: 19–23.
Gomez-Junyent J, Paredes-Zapata D, de las Parras ER, Gonzalez-Costello J, Ruiz-Arranz A, Cañizares R, Saugar J, Munñoz J, 2016. Real-time polymerase chain reaction in stool detects transmission of Strongyloides stercoralis from an infected donor to solid organ transplant recipients. Am J Trop Med Hyg 94: 897–899.
Dacal E, Saugar JM, Soler T, Azcárate JM, Jiménez MS, Merino FJ, Rodriguez E, 2017. Parasitological versus molecular diagnosis of strongyloidiasis in serial stool samples: how many? J Helminthol 23: 1–5.
Peters L, McCarthy AE, Faught C, 2009. Secondary Strongyloides stercoralis prophylaxis in patients with human T-cell lymphotropic virus type 1 infection: report of two cases. Int J Infect Dis 13: e501–e503.
Portugal R, Schaffel R, Almeida L, Spector N, Nucci M, 2002. Thiabendazole for the prophylaxis of strongyloidiasis in immunosuppressed patients with hematologic diseases: a randomized, double-blind placebo-controlled study. Haematologica 87: 663–664.
Levi GC, Kallás EG, Ramos Moreira Leite K, 1997. Disseminated Strongyloides stercoralis infection in an AIDS patient: the role of suppressive therapy. Braz J Infect Dis 1: 48–51.
Maguire JH, 2015. Intestinal nematodes (roundworms). Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 8th Ed. Philadelphia, PA: Elsevier Saunders, 3199–3207.
Weller PF, Leder K, 2017. Strongyloidiasis. Ryan ET, Baron EL, eds. UpToDate. Available at: https://www.uptodate.com/contents/strongyloidiasis?source=search_result&search=strongyloidiasis&selectedTitle=1∼97. Accessed September 1, 2017.
Santiago M, Leitão B, 2009. Prevention of Strongyloides hyperinfection syndrome: a rheumatological point of view. Eur J Intern Med 20: 744–748.
Davis JS et al. 2003. Prevention of opportunistic infections in immunosuppressed patients in the tropical top end of the northern territory. Commun Dis Intell Q Rep 27: 526–532.
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Strongyloides stercoralis chronic infection is frequently subclinical and thus under-recognized, although its increasing prevalence in nonendemic regions has implications for immunocompromised hosts. We present a 75-year-old male with stage II multiple myeloma who presented with relapse of Strongyloides infection after initial treatment, negative surveillance testing, and subsequent resumption of chemotherapy for his multiple myeloma. The optimal regimen for secondary prophylaxis against recurrent infections is unknown. Secondary prophylaxis should be considered for patients who recur and/or remain at high risk of recurrence because of ongoing immunosuppression. We implemented a prophylactic regimen of ivermectin 200 mcg/kg once monthly. In addition, improved laboratory assays for strongyloidiasis are needed to aid with diagnosis, monitoring of treatment response, and early detection of relapse.
Authors’ addresses: Keith Glenn, David A. Lindholm, Gregory Meis, Luisa Watts, and Nicholas Conger, Wright-Patterson Medical Center, Wright-Patterson Air Force Base, OH, E-mails: keith.r.glenn@gmail.com, david.lindholm@us.af.mil, gregory.meis@us.af.mil, luisa.watts.3@us.af.mil, and nicholas.conger@us.af.mil.
Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez P, 2006. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworms. Lancet 367: 1521–1532.
Montes M, Sawhney C, Barros N, 2010. Strongyloides stercoralis: there but not seen. Curr Opin Infect Dis 23: 500–504.
Genta RM, 1995. Strongyloides stercoralis. Blaser MJ, Smith PD, Ravdin JI, Greenberg HB, Guerran RL, eds. Infections of the Gastrointestinal Tract. New York, NY: Raven Press, 1197–1207.
Glinz S, Siue KD, Knopp S, Lohourignon LK, Yao KP, Steinmann P, Rinaldi L, Cringoli G, N’Groan E, Utzinger J, 2010. Comparing diagnostic accuracy of Kato-Katz, Koga agar plate, ether-concentration, and FLOTAC for Schistosoma mansoni and soil-transmitted helminthes. PLoS Negl Trop Dis 4: e754.
Croker C, Reporter R, Redelings M, Mascola L, 2010. Strongyloidiasis-related deaths in the United States, 1991–2006. Am J Trop Med Hyg 83: 422–426.
Dawson-Hahn EE, Greenberg SI, Domachowske JB, Olson BG, 2010. Eosinophilia and the seroprevalence of schistosomiasis and strongyloidiasis in newly arrived pediatric refugees: an examination of Centers for Disease Control and Prevention screening guidelines. J Pediatr 156: 1016–1018.
Gill GV, Welch E, Bailey JW, Bell DR, Beeching NJ, 2004. Chronic Strongyloides stercoralis infection in former British Far East prisoners of war. QJM 97: 789–795.
Puthiyakunnon S, Boddu S, Li Y, Zhou X, Wang C, Li J, Chen X, 2014. Strongyloidiasis—an insight into its global prevalence and management. PLoS Negl Trop Dis 8: e3018.
Viney ME, 1996. Developmental switching in the parasitic nematode Strongyloides ratti. Proc Biol Sci 263: 201–208.
Buonfrate D, Requena-Mendez A, Angheben A, Munoz J, Gobbi F, Van Den Ende J, Bisoffi Z, 2013. Severe strongyloidiasis: a systematic review of case reports. BMC Infect Dis 13: 78.
Olsen A, Van Lieshout L, Marti H, Polderman T, Polman K, Steinman P, Stothard R, Thybo S, Verweij JJ, Magnussen P, 2009. Strongyloidiasis—the most neglected of the tropical diseases? Trans R Soc Trop Med Hyg 103: 967–972.
Sarangarajan R, Ranganathan A, Belmonte AH, Tchertkoff V, 1997. Strongyloides stercoralis infection in AIDS. AIDS Patient Care STDS 11: 407–414.
Ferreira MS, Nishioka Sde A, Borges AS, Costa-Cruz JM, Rossin IR, Rocha A, Silvestre M, Nunes-Araujo F, 1999. Strongyloidiasis and infection due to human immunodeficiency virus: 25 cases at a Brazilian teaching hospital, including seven cases of hyperinfection syndrome. Clin Infect Dis 28: 154–155.
Pukkila-Worley R, Nardi V, Branda JA, 2014. Case 28-2014: a 39-year-old man with a rash, headache, fever, nausea and photophobia. N Engl J Med 371: 1051–1060.
Link K, Orenstein R, 1999. Bacterial complications of strongyloidiasis: Streptococcus bovis meninigitis. South Med J 92: 728–731.
Jain AK, Agarwal SK, el-Sadr W, 1994. Streptococcus bovis bacteremia and meninigitis associated with Strongyloides stercoralis colitis in a patient infected with human immunodeficiency virus. Clin Infect Dis 18: 253–254.
De Silva T, Raychaudhuri M, Poulton M, 2005. HIV infection associated with Strongyloides stercoralis colitis resulting in Streptococcus bovis bacteraemia and meningitis. Sex Transm Infect 81: 276–277.
Linder JD, Monkemuller KE, Lazenby AJ, Wilcox CM, 2000. Streptococcus bovis bacteremia associated with Strongyloides stercoralis colitis. Gastrointest Endosc 52: 796–798.
Keiser PB, Nutman TB, 2004. Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev 17: 208–217.
Centers for Disease Control and Prevention, 2017. Strongyloidiasis. Available at: https://www.cdc.gov/parasites/strongyloides/health_professionals/index.html#tx. Accessed August 17, 2017.
Tanton DD, Durning S, Chambers S, 2002. Pulmonary hyperinfection with Strongyloides stercoralis in an immunocompetent patient. J Gen Intern Med 17: 72–73.
Husni RN, Gordon SM, Longworth DL, Adal KA, 1996. Disseminated Strongyloides stercoralis infection in an immunocompetent patient. Clin Infect Dis 23: 663.
Scowden EB, Schaffner W, Stone WJ, 1978. Overwhelming strongyloidiasis: an unappreciated opportunistic infection. Medicine 57: 527–544.
Schaffel R, Nucci M, Carvalho E, Braga M, Almeida L, Portugal R, Pulcheri W, 2001. The value of an immunoenzymatic test (enzyme-linked immunosorbent assay) for the diagnosis of strongyloidiasis in patients immunosuppressed by hematologic malignancies. Am J Trop Med Hyg 65: 346–350.
Abdalla J, Saad M, Myers JW, Moorman JP, 2005. An elderly man with immunosuppression, shortness of breath and eosinophilia. Clin Infect Dis 40: 1464.
Biggs BA, Caruana S, Mihrshahi S, Jolley D, Leydon J, Chea L, Nuon S, 2009. Management of chronic strongyloidiasis in immigrants and refugees: is serologic testing useful? Am J Trop Med Hyg 80: 788–791.
Kobayashi J, Sato Y, Toma H, Takara M, Shiroma Y, 1994. Application of enzyme immunoassay for postchemotherapy evaluation of human strongyloidiasis. Diagn Microbiol Infect Dis 18: 19–23.
Gomez-Junyent J, Paredes-Zapata D, de las Parras ER, Gonzalez-Costello J, Ruiz-Arranz A, Cañizares R, Saugar J, Munñoz J, 2016. Real-time polymerase chain reaction in stool detects transmission of Strongyloides stercoralis from an infected donor to solid organ transplant recipients. Am J Trop Med Hyg 94: 897–899.
Dacal E, Saugar JM, Soler T, Azcárate JM, Jiménez MS, Merino FJ, Rodriguez E, 2017. Parasitological versus molecular diagnosis of strongyloidiasis in serial stool samples: how many? J Helminthol 23: 1–5.
Peters L, McCarthy AE, Faught C, 2009. Secondary Strongyloides stercoralis prophylaxis in patients with human T-cell lymphotropic virus type 1 infection: report of two cases. Int J Infect Dis 13: e501–e503.
Portugal R, Schaffel R, Almeida L, Spector N, Nucci M, 2002. Thiabendazole for the prophylaxis of strongyloidiasis in immunosuppressed patients with hematologic diseases: a randomized, double-blind placebo-controlled study. Haematologica 87: 663–664.
Levi GC, Kallás EG, Ramos Moreira Leite K, 1997. Disseminated Strongyloides stercoralis infection in an AIDS patient: the role of suppressive therapy. Braz J Infect Dis 1: 48–51.
Maguire JH, 2015. Intestinal nematodes (roundworms). Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 8th Ed. Philadelphia, PA: Elsevier Saunders, 3199–3207.
Weller PF, Leder K, 2017. Strongyloidiasis. Ryan ET, Baron EL, eds. UpToDate. Available at: https://www.uptodate.com/contents/strongyloidiasis?source=search_result&search=strongyloidiasis&selectedTitle=1∼97. Accessed September 1, 2017.
Santiago M, Leitão B, 2009. Prevention of Strongyloides hyperinfection syndrome: a rheumatological point of view. Eur J Intern Med 20: 744–748.
Davis JS et al. 2003. Prevention of opportunistic infections in immunosuppressed patients in the tropical top end of the northern territory. Commun Dis Intell Q Rep 27: 526–532.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 296 | 207 | 9 |
Full Text Views | 505 | 14 | 0 |
PDF Downloads | 213 | 12 | 0 |