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Hyperinfection Syndrome with Strongyloides stercoralis

[+] Article and Author Information

Supported in part by hematology training grant T1 AM 5302, National Institutes of Health, Bethesda, Md.

Presented in part in September 1968, at the XIIth Congress of the International Society of Hematology, New York, N.Y.

▸Requests for reprints should be addressed to N. Maldonado, M.D., Hematology Section, University Hospital, Caparra Heights, Station, Caparra Heights, Puerto Rico 00935

San Juan,Puerto Rico

Ann Intern Med. 1970;72(2):199-204. doi:10.7326/0003-4819-72-2-199
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Infection with the parasitic nematode, Strongyloides stercoralis, can lead to death in patients with various clinical disorders. Alteration of the parasite—host relationship may lead to hyperinfection characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram-negative or opportunistic fungal sepsis, coma, and death. During the last 3 years nine such patients were studied in the hematology section of a 300-bed university hospital. Eight patients died, four in spite of energetic treatment with thiabendazole. Since diagnosis of hyperinfection is often made only at autopsy, its presence should be suspected in hematologic patients and patients with diseases of altered immunity, such as leprosy and systemic lupus erythematosus. Since early diagnosis is essential to avoid fatalities, laboratory technicians and physicians dealing with such patients as well as with large population groups that harbor this parasite (for example, Puerto Ricans) should be alerted.





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