Strongyloides Hyperinfection Syndrome and Severe Malnutrition in an Immunocompetent Patient

Abstract

Aims: Strongyloides Hyperinfection Syndrome (SHS) and disseminated Strongyloidiasis have been extensively reported in immunocompromised patients. In SHS, large parasitic loads of larvae cause symptoms mainly limited to the gastrointestinal tract and lung, whereas in the disseminated form multiple organs can be affected with high mortality if inappropriately treated. Case Presentation: Here we present an unusual case of a 28-year-old (HIV negative) patient with confirmed untreated Helicobacter pylori, symptoms of gastric and pulmonary hyperinfection complicated with severe weight loss, respiratory symptoms with hemoptysis and refeeding syndrome. Discussion: The diagnosis was based on histological confirmation of the parasite in the gastric mucosal biopsy and stool analysis. The patient was successfully treated with ivermectin and discharged in reasonable medical conditions. Conclusion: This case illustrates the importance of considering Strongyloides Hyperinfection in immunocompetent patients presenting with chronic vomiting, weight loss and anemia, especially in developmental countries.