Strongyloidosis Hyperinfection Syndrome in an HIV-Infected Patient: A Rare Manifestation of Immune Reconstitution Inflammatory Syndrome

Parasitic infections such as Strongyloides stercoralis and HIV have been reported to coexist, particularly in resource-limited settings such as India. In an immunocompromised host, S. stercoralis can progress to strongyloidiasis hyperinfection syndrome (SHS). However, SHS is not common in patients w...

Full description

Saved in:
Bibliographic Details
Main Authors: Kartik Natrajan, Mahenderkumar Medisetty, Raviraj Gawali, Ajit Tambolkar, Divya Patel, Vinay Thorat, Nachiket Dubale, Vrushali Khirid, Chinmay Saraf, Ameet Dravid
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2018/6870768
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Parasitic infections such as Strongyloides stercoralis and HIV have been reported to coexist, particularly in resource-limited settings such as India. In an immunocompromised host, S. stercoralis can progress to strongyloidiasis hyperinfection syndrome (SHS). However, SHS is not common in patients with advanced HIV disease. Immune reconstitution inflammatory syndrome (IRIS) developing after initiation of antiretroviral therapy (ART) can target multiple pathogens including S. stercoralis. The authors present here a 46-year-old HIV-infected female who was recently diagnosed with HIV-1 infection, started ART, and developed SHS. Her upper GI endoscopy revealed severe gastroduodenitis, and X-ray chest showed extensive bilateral pneumonitis. We could identify S. stercoralis in induced sputum and duodenal biopsy. We could also identify gut inflammation to restrict invading parasites. After receiving antihelminthic therapy, she showed improvement, a course of events that fit the diagnosis of unmasking S. stercoralis IRIS.
ISSN:2090-6625
2090-6633