From the Guidelines
Disseminated Strongyloides is called hyperinfection syndrome or disseminated strongyloidiasis. This condition is a severe, life-threatening form of Strongyloides stercoralis infection that occurs when the parasite spreads throughout the body beyond its normal migration pattern, as noted in the treatment guidelines for opportunistic infections in inflammatory bowel disease 1.
Key Characteristics
- Typically develops in immunocompromised individuals, particularly those on corticosteroid therapy
- Can cause widespread damage by invading multiple organs including the lungs, liver, brain, and other tissues
- Mortality rate can exceed 70% due to massive parasite burden and secondary bacterial infections
Treatment
- Requires ivermectin, with the possibility of combination therapy with albendazole in severe cases, as indicated by the need for early implementation of therapy such as parenteral ivermectin for disseminated strongyloidiasis 1
- Early diagnosis and aggressive treatment are essential to prevent rapid progression to multi-organ failure. Some key points to consider in the diagnosis of hyperinfection syndrome include:
- Eosinophilia is present in up to 70% of patients and should raise suspicion of infection with S. stercoralis
- Severe cases may not have eosinophilia, making early suspicion and diagnosis critical 1.
From the Research
Disseminated Strongyloides
- Disseminated Strongyloides is often referred to as Strongyloides hyperinfection syndrome or disseminated strongyloidiasis 2, 3, 4.
- This condition occurs when the parasite reproduces within the host, leading to a severe infection that can affect multiple organs 3, 4.
- Disseminated Strongyloides is commonly seen in immunocompromised patients, particularly those taking corticosteroids or other immunosuppressants 2, 3, 4.
- The condition can present with a range of symptoms, including cutaneous lesions, respiratory failure, and sepsis 3, 4.
Characteristics of Disseminated Strongyloides
- Disseminated Strongyloides is characterized by the presence of filariform larvae in the bloodstream, tissues, or other bodily fluids 3, 5.
- The infection can be diagnosed by identifying the larvae in stool, sputum, or tissue samples 2, 3, 5.
- Treatment of disseminated Strongyloides typically involves the use of antihelminthic medications, such as ivermectin or albendazole, often in combination and for an extended duration 5, 4, 6.