title: Hyperinfective strongyloidiasis in the medical ward: review of 27 cases in 5 years.
abstract: BACKGROUND
  Hyperinfective strongyloidiasis is rare, but the mortality rate is very high. It occurs most commonly in immunocompromised patients. We reviewed the clinical presentation and mortality rate of cases managed in our facility.
  
  
  METHODS
  Twenty-seven patients with hyperinfective strongyloidiasis admitted to our medical ward over a 5-year period were prospectively studied.
  
  
  RESULTS
  In our study, there were 18 males and 9 females (mean age, 58 years). Weight loss, gastrointestinal symptoms, hypoproteinemia, and anemia were the main clinical presentations. Mortality rate was 26%; human T-lymphotropic virus (HTLV-1) infection, chronic alcoholism, eosinopenia, sepsis, and prerenal azotemia on admission were poor prognostic factors. HTLV-1 infection was the main underlying disease in 71% of patients, and 44% of patients had a history of chronic alcoholism.
  
  
  CONCLUSIONS
  Early diagnosis and treatment with thiabendazole may reduce mortality in hyperinfective strongyloidiasis. Hyperinfective strongyloidiasis may also be a clinical marker of HTLV-1 infection in areas where both entities are endemic or in immigrants from such areas.
authors.affiliation: Department of Medicine, Princess Margaret Hospital, Roseau, Dominica, West Indies.
authors.forename: Olayinka
authors.initials: O
authors.lastname: Adedayo
authors.forename: Gerald
authors.initials: G
authors.lastname: Grell
authors.forename: Peter
authors.initials: P
authors.lastname: Bellot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications / Q000276:immunology; D004802:Eosinophilia / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D015490:HTLV-I Infections / Q000150:complications / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007411:Intestinal Diseases, Parasitic / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000209:etiology; D013322:Strongyloidiasis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D015431:Weight Loss