Complicated and fatal Strongyloides infection in Canadians: risk factors, diagnosis and management.
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).
Lim
Sue
S
Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto General Hospital--University Health Network, Toronto, Ont.
Katz
Kevin
K
Krajden
Sigmund
S
Fuksa
Milan
M
Keystone
Jay S
JS
Kain
Kevin C
KC
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*