Opportunistic Strongyloides Stercoralis Infection in an Immunocompromised Patient.

ABSTRACT

Strongyloides stercoralis is an intestinal nematode that infects human percutaneously and has a complex life cycle including a direct, an autoinfective and a non-parasitic freeliving developmental cycle. Strongyloidiasis has a worldwide distribution, and usually causes mild or asymptomatic infection. However hyperinfection syndrome can cause significant morbidity and mortality in immunocompromised states such as malignancy, HIV infection, or immunosuppressive agent administration. We report a case of a 37-year old male HIV positive patient admitted in male medical ward, RIMS with severe diarrhoea, pain abdomen, generalized weakness and history of diarrhoea off and on for past one month. His CD4+ T- lymphocyte count was 116 cell/microlitre and the patient was on antiretroviral therapy. Stool examination reveals larvae of Strongyloides stercoralis. Stool culture was negative for pathogenic bacteria and fungi. Special staining for detection of intestinal coccidian parasites and microsporidiosis was also negative .The patient was successfully treated with combined therapy of albendazole(400mg) and ivermectin(6mg) daily for 3days.