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Colegio de Medicina Interna de México.

2018, Number 6

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Med Int Mex 2018; 34 (6)

Strongyloidiasis disseminated in a patient with human immunodeficiency virus (HIV) infection

Rivas-Godoy AF, Izaguirre-González AI, Maradiaga-ReyesEF, Bu-Figueroa E, García-Aguilar JA

Language: Spanish
References: 16
Page: 973-977
PDF size: 411.34 Kb.


ABSTRACT

Strongyloides stercoralis is a parasite belonging to the group of nematodes, endemic in rural regions of countries with tropical and subtropical climate where it can affect between 30 and 100 million people. This infection is commonly asymptomatic and may remain hidden for decades, but changes in the immune system favor the development of a syndrome of hyperinfection or disseminated infection, with the frequency estimated in chronic stages between 1.5 and 2.5%. This paper reports the case of a female, 40 year-old patient, with HIV/AIDS and pulmonary tuberculosis, who attended the emergency service of the University School Hospital, Tegucigalpa, Honduras, with a history of diarrheic evacuations and abdominal pain of one month of evolution, accompanied by vomiting preceded by nausea, fever and weight loss approximately of 12 kg from the onset of symptoms. Laboratory tests reported severe anemia, leukopenia and hydroelectrolytic disorders; general examination of faeces revealed: larvae of Strongyloides stercoralis, with abundant polymorphonuclear leukocytes. Antibiotic treatment was started with sulfas, quinolones and imidazoles, but the patient progressed unfavorably and died on the eighth hospital day. It is important to consider the possibility of a disseminated infection in patients with HIV/AIDS, because the delay in the beginning of the treatment and a compromised immune system favor the proliferation of the parasite increasing the mortality of the patient.


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