From the Guidelines
The use of corticosteroids (steroids) can worsen nematode infections, such as Strongyloides stercoralis.
Relationship Between Corticosteroids and Nematode Infections
- Corticosteroids can lead to hyper-infection in patients with Strongyloides stercoralis infection, particularly in endemic areas 1.
- In areas where strongyloidiasis is endemic, presumptive treatment with ivermectin for helminth infection may be appropriate for covid-19 patients treated with corticosteroids 1.
- The risk of worsening nematode infections with corticosteroid use should be considered, especially in patients with endemic infections such as strongyloidiasis 1.
- Empiric treatment or diagnosis of strongyloidiasis may be considered in endemic areas if corticosteroids are used 1.
- The use of corticosteroids in patients with nematode infections requires careful consideration of the potential risks and benefits, particularly in resource-limited settings 1.
From the Research
Nematode Infection and Corticosteroids
- The relationship between nematode infection and the use of corticosteroids (steroids) is complex and has been studied in various contexts 2, 3, 4, 5.
- Corticosteroids have been shown to increase the susceptibility to infections, including those caused by nematodes, by suppressing the host's immune system 3.
- In the case of Strongyloides stercoralis, a gastrointestinal nematode, glucocorticoid therapy can lead to a rapid and often lethal hyperinfection syndrome 4.
- The use of corticosteroids can also alter the parasite's development and survival, with steroid-nuclear hormone receptor signaling playing a crucial role in regulating larval development and adult lifespan in parasitic nematodes 5.
Mechanisms of Interaction
- The exact mechanisms by which corticosteroids interact with nematode infections are not fully understood, but it is thought that they may promote hyperinfection by eliminating essential host protective mechanisms and/or dysregulating parasite development 4.
- Signaling between parasites and their hosts' immune systems also occurs, serving to modulate these responses and allow chronic infection 5.
- Further research is needed to understand the complex interactions between corticosteroids, nematode infections, and the host's immune system, and to develop effective strategies for preventing and treating these infections 2, 3, 4, 5.
Clinical Implications
- The use of corticosteroids in patients with nematode infections should be carefully considered, as it may increase the risk of hyperinfection and other complications 3, 4.
- Clinicians should be aware of the potential risks and benefits of corticosteroid therapy in patients with nematode infections, and monitor them closely for signs of hyperinfection or other adverse effects 3, 4.