Hiperinfección por Strongyloides stercoralis (Bavay 1876; Stiles y Hassall 1902) en Uruguay

Zaida Arteta; Ximena Mencía; Alba Larre Borges; Elbio Gezuele; Luis Calegari

Authors

Zaida Arteta Universidad de la República, Facultad de Medicina, Instituto de Higiene, Departamento de Parasitología y Micología, Asistente
Ximena Mencía Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Médica 1, Medicina Interna, Residente
Alba Larre Borges Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Médica 1, Profesora Agregada
Elbio Gezuele Universidad de la República, Facultad de Medicina, Instituto de Higiene, Departamento de Parasitología y Micología, Profesor Agregado
Luis Calegari Universidad de la República, Facultad de Medicina, Instituto de Higiene, Departamento de Parasitología y Micología, Profesor Director

Keywords:

STRONGYLOIDES STERCORALIS, STRONGYLLOIDIASIS, STRONGYLIDA INFECTIONS

Abstract

Strongyloidiasis is a general intestinal parasitosis, but it usually appears in warm moist areas.
Symptoms might produce severe intestinal reactions, it perpetuates by autoinfection and might lead to hyper-infection in immunocompromised patients by massive and systemic dissemination of larvae.
A 18-year-old woman, HIV positive, was admitted to the hospital because of Strongyloides stercoralis hyper-infection. Three months before admission she had temperature and she did not receive antiretroviral treatment.
On arrival, the patient was in bad condition and respiratory failure with disseminated subcrepitant stertors was observed. She was treated with trimetroprim-sulfametoxazol, hydrocortisone and non-invasive ventilation because of suspicion of pneumocistosis. Lately, the microscopic study of the bronchial alveolar lavage showed filariform larvae identified as Strongyloides stercoralis. When strongyloidiasis was diagnosed, a treatment with ivermectine started the fourth hospital day but the patient died hours later.
Strongyloidiasis prevalence in Uruguay is low. However, since geo-helmintiasis is growing significantly in many areas of the country, associated risk should be considered.
Strongyloidiasis should be assessed with precise methods in immunocompromised patients.

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