title: Late diagnosis of central nervous system involvement associated with lethal dissemination of Strongyloides stercoralis in an advanced HIV patient from Nigeria.
abstract: Strongyloides stercoralis is a ubiquitous intestinal nematode, endemic in tropical and subtropical areas, with an unusual life cycle in which autoinfection can take place. In the immunosuppressed host, autoinfection is accelerated and larvae can spread in all organs, leading to hyperinfection syndrome or to disseminated disease. Strongyloidiasis is presently rare in Western Countries, often with delayed diagnosis due to a lack of clinical suspicion, nonspecific presentation, and low parasite intestinal output. Foreign HIV-infected patients from endemic areas are at increased risk of severe disease caused by this parasite. Here we report the case of a patient with disseminated lethal disease, whose disseminated state was missed 2 years prior to the current presentation. This emblematic case shows that intestinal parasitic infections, highly prevalent in Sub-Saharan Africa, Southeast Asia, and Latin America, are difficult to recognize but should be thoroughly investigated and excluded in high-risk patients, to prevent severe long-term lethal sequelae.
authors: Infectious Disease Clinic, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy.
authors: Tamara
authors: T
authors: Ursini
authors: Ennio
authors: E
authors: Polilli
authors: Paolo
authors: P
authors: Fazii
authors: Alfio
authors: A
authors: Ieraci
authors: Giulia
authors: G
authors: Sindici
authors: Giustino
authors: G
authors: Parruti
mesh_terms: D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D044383:Black People; D020809:Central Nervous System Helminthiasis / Q000175:diagnosis* / Q000188:drug therapy; D057210:Delayed Diagnosis; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009549:Nigeria; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000871:Anthelmintics