title: Complicated and fatal Strongyloides infection in Canadians: risk factors, diagnosis and management.
abstract: Strongyloidiasis, which is caused by the nematode Strongyloides stercoralis, is a common and persistent infection, particularly in developing countries. In the setting of compromised cellular immunity, it can result in fulminant dissemination with case-fatality rates of over 70%. The majority of new Canadian immigrants come from countries where Strongyloides is highly endemic; therefore, the burden of Strongyloides may be underappreciated in Canada. Because early diagnosis and therapy can have a marked impact on disease outcome, screening for this infection should be considered mandatory for patients who have a history of travel or residence in a disease-endemic area and risk factors for disseminated disease (e.g., corticosteroid use and human T-lymphotropic virus type I infection).
authors.affiliation: Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto General Hospital--University Health Network, Toronto, Ont.
authors.forename: Sue
authors.initials: S
authors.lastname: Lim
authors.forename: Kevin
authors.initials: K
authors.lastname: Katz
authors.forename: Sigmund
authors.initials: S
authors.lastname: Krajden
authors.forename: Milan
authors.initials: M
authors.lastname: Fuksa
authors.forename: Jay S
authors.initials: JS
authors.lastname: Keystone
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Kain
mesh_terms: D000818:Animals; D002170:Canada / Q000453:epidemiology; D003937:Diagnosis, Differential; D006801:Humans; D012307:Risk Factors; D013321:Strongyloides / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*