Strongyloides stercoralis hyperinfection syndrome in a patient with non-Hodgkin's lymphoma: report of a fatal case
Keywords:
STRONGYLOIDES STERCORALIS; LINFOMA NO HODGKIN; HIPERINFECCIÓN; HUÉSPED INMUNODEPRIMIDO HUÉSPED., STRONGYLOIDES STERCORALIS; LYMPHOMA, NON-HODGKIN; IMMUNOCOMPROMISED HOST.Abstract
Introduction: strongyloides stercoralis hyperinfection syndrome is a serious and potentially life-threatening condition caused by this intestinal nematode, which occurs especially in people with weakened immune systems.
Objective: to describe a clinical case where a patient with non-Hodgkin lymphoma developed Strongyloides stercoralis hyperinfection syndrome.
Case presentation: a 67-year-old male patient with CD20+ non-Hodgkin lymphoma developed a disseminated Strongyloides stercoralis infection, confirmed by parasite identification in peripheral blood, duodenal biopsy, and cerebrospinal fluid samples. After prophylactic deworming, the patient presented gastrointestinal and subdural bleeding, Aspergillus pneumonia, and Strongyloides stercoralis reactivation, confirmed in the duodenum and cerebrospinal fluid. He developed nosocomial infections due to Acinetobacter baumannii and Klebsiella pneumoniae KPC. He progressed with neurological deterioration, ophthalmoplegia, and refractory septic shock, dying after 28 days of hospitalization. This case highlights the risk of severe strongyloidiasis in immunosuppressed patients, even after negative screening.
Conclusions: the case underscores the importance of implementing primary preventive measures, such as screening before starting corticosteroid treatment, especially in endemic areas, where physicians should maintain high clinical suspicion. Aggressive, early treatment with targeted therapies can control disease progression and significantly improve clinical outcomes, reducing the associated high morbidity and mortality.
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