Strongyloides stercoralis in Immunocompromised Patients

Abstract Strongyloides hyperinfection diagnosis has been associated with high mortality. We present a case series of 3 immunocompromised patients who had severe infection of Strongyloides including 1 fatal case. The first patient was on chronic steroids and cyclophosphamide for acquired hemophilia. She was admitted for sepsis with bacteremia and multifocal pneumonia, acute respiratory distress syndrome, and sputum positive for Strongyloides . The second patient was on chronic steroids and infliximab and developed septic shock secondary to multifocal pneumonia, enterococcal bacteremia, and disseminated strongyloidiasis with hyperinfection. The third patient on chronic steroids and immunosuppressive therapy presented with worsening dyspnea and cough and was found to have strongyloidiasis in bronchoalveolar lavage fluid. Early identification and treatment of at-risk population particularly the immunocompromised could potentially reduce the risk of mortality.