title: A case of Strongyloides hyperinfection syndrome in the setting of persistent eosinophilia but negative serology.
abstract: Strongyloides stercoralis is a unique intestinal nematode with the ability to replicate and complete its life cycle without leaving the host. We report a fatal case of Strongyloides hyperinfection syndrome in a patient who had persistent eosinophilia for several years but negative Strongyloides serology. Our case suggests that ELISA serologies cannot solely be relied upon to diagnose Strongyloides stercoralis infection; history and clinical judgment remain crucial to this diagnosis.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mount Sinai Beth Israel, First Avenue at 16(th) St, New York, NY, 10003. Electronic address: berilonson@gmail.com.
authors.forename: Stephen
authors.initials: S
authors.lastname: Osiro
authors.affiliation: Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY, 10029.
authors.forename: Camille
authors.initials: C
authors.lastname: Hamula
authors.affiliation: Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place 1090, New York, NY, 10029.
authors.forename: Allison
authors.initials: A
authors.lastname: Glaser
authors.affiliation: Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place 1090, New York, NY, 10029.
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Rana
authors.affiliation: Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place 1090, New York, NY, 10029.
authors.forename: Dallas
authors.initials: D
authors.lastname: Dunn
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood*; D000977:Antiparasitic Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000469:parasitology; D004797:Enzyme-Linked Immunosorbent Assay; D004802:Eosinophilia / Q000097:blood*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*
chemical_list: D000909:Antibodies, Helminth; D000977:Antiparasitic Agents; D007559:Ivermectin; D015766:Albendazole
keywords: Eosinophilia; Hyperinfection; Serology; Strongyloidiasis