Strongyloidiasis: the most neglected tropical disease?

Estrongiloidiasis ¿la enfermedad tropical más desatendida?

Strongyloidiasis is caused by Strongyloides stercoralis, an intestinal helminth which is widely distributed in tropical and subtropical areas with varied clinical presentation. Herein we present a patient with S. stercoralis infection with pleural, gastrointestinal tract and hematological manifestations. The diagnosis was confirmed by upper GI endoscopy. The patient received treatment with benzimidazole derivatives (albendazole), for ivermectin is difficult to get due to its use during the current SARS COV 2 pandemic in our country.

1. Greaves D, Coggle S, Pollard C, Aliyu SH, Moore EM. Strongyloides stercoralis infection. BMJ. 2013;347:f4610. https://doi.org/10.1136/bmj.f4610
2. World Gastroenterology Organization. Manejo de la estrongiloidiasis [Internet]. 2018 (Cobnsultado 4 April 2021). Disponible en: https://www.worldgastroenterology.org/guidelines/global-guidelines/management-of-strongyloidiasis/management-of-strongyloidiasis-spanish
3. Center for Disease Control and Prevention. Parasites – Strongyloides. Resources for Health Professionals [internet]. Atlanta, GA: Centros para el Control y Prevención de Enfermedades; 2016 [Consultado 13 de marzo de 2019]. Disponible en: https://www.cdc.gov/parasites/strongyloides/health_professionals/index.html
4. Schär F, Trostdorf U, Giardina F, Khieu V, Muth S, Marti H, Vounatsou P, Odermatt, P. Strongyloides stercoralis: PLoS Negl Trop Dis. 2013;7(7):e2288. https://doi.org/10.1371/journal.pntd.0002288.
5. Olsen A, van Lieshout L, Marti H, Polderman T, Polman K, Steinmann P, Stothard R, Thybo S, Verweij JJ, Magnussen P. Strongyloidiasis--the most neglected of the neglected tropical diseases? Trans R Soc Trop Med Hyg. 2009;103(10):967-72. doi: 10.1016/j.trstmh.2009.02.013.
6. Keiser PB, Nutman TB. Strongyloides stercoralis in the Immunocompromised Population. Clin Microbiol Rev. 2004;17(1):208-17. doi: 10.1128/cmr.17.1.208-217.2004.
7. Rodríguez Calabuig D, Igual Adell R, Oltra Alcaraz C, Sánchez Sánchez P, Bustamante Balen M, Parra Godoy F, Nagore Enguidanos E. Actividad laboral agrícola y estrongiloidiasis. Estudio caso-control, Revista Clínica Española. 2001;201(2):81-84. https://doi.org/10.1016/S0014-2565(01)70755-2
8. Azira NM, Abdel Rahman MZ, Zeehaida M. Review of patients with Strongyloides stercoralis infestation in a tertiary teaching hospital, Kelantan. Malays J Pathol. 2013;35(1):71-6.
9. Siddiqui AA, Berk SL. Diagnosis of Strongyloides stercoralis infection. Clin Infect Dis. 2001;33(7):1040-7. doi: 10.1086/322707
10. Al Hadidi, M., Shaaban, H., Jumean, KH y Peralta, P. Loeffler's Syndrome Secondary to Hyperinfection by Strongyloides stercoralis Associated with Methotrexate in a Patient with Rheumatoid Arthritis. Journal of Global Infectious Diseases. 2018;10(1):29-30. https://doi.org/10.4103/jgid.jgid_69_17
11. Emad A. Exudative eosinophilic pleural effusion due to Strongyloides stercoralis in a diabetic man. South Med J. 1999;92(1):58-60. doi: 10.1097/00007611-199901000-00011
12. Agrawal V, Agarwal T, Ghoshal UC. Intestinal strongyloidiasis: a diagnosis frequently missed in the tropics. Trans R Soc Trop Med Hyg. 2009;103(3):242-6. doi: 10.1016/j.trstmh.2008.08.009
13. Goyal SB. Intestinal strongyloidiasis manifesting as eosinophilic pleural effusion. South Med J. 1998;91(8):768-9. doi: 10.1097/00007611-199808000-00016.
14. Pérez F, Núñez F, Martín N, Cabrera R, Rodríguez E. Falla orgánica múltiple por estrongiloidiasis diseminada: Comunicación de un caso. Rev Chi Infectol. 2021;29(3):344-347. https://dx.doi.org/10.4067/S0716-10182012000300016
15. Nabeya D, Haranaga S, Parrott G, Kinjo T, Nahar S, Tanaka T, Hirata T, Hokama
16. A, Tateyama M, Fujita J. Pulmonary strongyloidiasis: Assessment between manifestation and radiological findings in 16 severe strongyloidiasis cases. BMC Infect Dis. 2017;17(1):320. doi: 10.1186/s12879-017-2430-9