Strongyloidiasis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

If strongyloidiasis is left untreated, the infection can disseminate and transform into hyperinfection 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 who are otherwise immunocompromised), 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 patients with a suppressed immune system.

Natural history

If left untreated, the subclinical strongyloidiasis can disseminate and transform into hyperinfection syndrome, which has a mortality rate of 90%.

Complications

Complications that can develop as a result of strongyloidiasis are:

• Disseminated strongyloidiasis(especially in patients with HIV and other immunosuppromised conditions.
• Eosinophilic pneumonia
• Malnutrition
• 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 patients with a suppressed immune system. Strongyloidiasis could be severe and life-threatening in specific groups including:

• Those who use 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%.