Hyperinfection with strongyloides stercoralis - abstract

ABSTRACT

A combination of the history, clinical signs and the presence of a high proportion of the invasive filariform larvae, is sufficiently diagnostic of Strongyloides stercoralis hyperinfection. Early recognition and effective treatment of this condition can avoid the occasionally associated mortality. The clinical, laboratory, radiological and histological aspects of 23 patients with the condition seen at the University Hospital of the West Indies and not previously reported, are presented. The course of hyperinfection was found to be predominantly a chronic one, in which the prevalence of abdominal pain, weight-loss, vomiting and hypoalbuminaemia was greater than 90 percent but was acute and fulminating in 3 cases. The overall mortality was 35 percent. Radiological abnormalities were maximal in the duodenum and jejunum, mucosal cedema, dilation and reverse peristalsis being commonest. Treatment with conventional drugs did not uniformly cause complete eradication of the organism, but in vitro, in vivo and clinical comparisons indicate that a new drug Levamisole is significantly more effective than Thaibendozole against strongyloides stercoralis (AU)