Strongyloidiasis natural history, complications and prognosis
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Overview
If strongyloidiasis is left untreated, the infection can disseminate and transform into hyper infection syndrome which has a mortality rate of 90%. Complications that can develop as a result of strongyloidiasis are disseminated strongyloidiasis (especially in patients with HIV or other immunocompromised conditions), eosinophilic pneumonia, malnutrition, and malabsorption. With appropriate treatment, people should make a full recovery. Treatment needs to be repeated often. Infections that are severe or widespread often have a poor outcome, especially in people with a suppressed immune system.
Natural history
If left untreated, the subclinical strongyloidiasis can disseminate and transform into hyper-infection syndrome with a mortality rate of 90%.
Complications
Complications that can develop as a result of strongyloidiasis are:
- Disseminated strongyloidiasis, especially in patients with HIV or who are otherwise immunosuppressed
- Eosinophilic pneumonia
- Malnutrition due to problems absorbing nutrients from the gastrointestinal tract (malabsorption)
Prognosis
With appropriate treatment, people should make a full recovery. Sometimes, treatment needs to be repeated. Infections that are severe or widespread often have a poor outcome, especially in people with immunosuppression. Strongyloidiasis could be severe and life-threatening in specific groups including:
- Those who use of oral or intravenous steroids, for example, in patients with asthma, chronic obstructive pulmonary disease (COPD) exacerbations, lupus, gout, or in persons using steroids for immunosuppression or symptomatic relief
- Those with HTLV-1 infection
- Those with Hematologic malignancies such as leukemia or lymphoma
- Transplant recipients
Even with treatment, disseminated strongyloidiasis and hyperinfection syndrome have a mortality rate of 90%.