Hyperinfection with strongyloides stercoralis

ABSTRACT

A case of Strongyloides hyperinfection syndrome, associated with corticosteroid therapy is described here. A 69-year-old male patient was admitted with a minor stroke. A history of headache arid a markedly elevated ESR prompted a temporal artery biopsy, which was consistent with temporal arteritis. Treatment was started with prednisolone 60 mg per day and the patient was discharged for follow-up. He was readmitted with a dense hemiplegia arid high fever. Blood culture grew E.co/i. He rapidly deteriorated arid died with evidence of disseminated intravascular coagulation and acute respiratory distress syndrome. Wet smears of sputum were positive for larvae of Strongyloides sterco ru/is, suggesting generalised infection. The importance of early diagnosis arid therapy, and screening methods for detection of parasites in stool are discussed