Andres Ricaurte Fajardo on a Strongyloides Stercoralis Hyperinfection with Thrombosis
Andres Ricaurte Fajardo, Neurology resident at University Pontificia Javeriana, shared on LinkedIn:
”I am proud to share our latest systematic review on the underrecognized association between Strongyloides stercoralis hyperinfection syndrome and thrombotic complications published at New Microbes and New Infections (Q2 Journal).
We systematically analyzed 16 reported cases of SHS with thrombosis, highlighting a broad spectrum of events, including deep vein thrombosis, pulmonary embolism, portal and renal vein thrombosis, intracardiac thrombi, thrombotic microangiopathy, and disseminated intravascular coagulation.
Despite treatment with ivermectin-based regimens, mortality exceeded 30%, especially in immunosuppressed patients and those presenting with shock or multifocal thrombosis.
Key Take-Home Messages
Strongyloides hyperinfection should be actively considered in immunosuppressed patients (including those on chronic corticosteroids, chemotherapy, or other immunomodulators) who present with sepsis, shock, or unexplained thrombosis.
Thrombotic involvement in SHS is heterogeneous and often multifocal, affecting venous, arterial, and microvascular territories—including catastrophic presentations such as DIC.
Diagnostic delay is common and frequently related to nonspecific symptoms and the absence of eosinophilia in patients on steroids, contributing to high mortality.
Ivermectin remains the cornerstone of therapy, sometimes combined with albendazole, but treatment regimens are variable; early empiric initiation in high-risk patients is critical.
There is an urgent need for standardized diagnostic approaches, systematic screening in endemic settings, and better reporting of thrombotic outcomes in strongyloidiasis.”
Read the full article here.
Article: Strongyloides stercoralis hyperinfection with thrombosis: A systematic review of case reports
Authors: Darío S. López-Delgado, Carlos A. Narváez, Roberto Bonfante-Villalobos, Joshua Emmanuel Arteaga, Hector Fabio Sanchez-Galvez, Andres Ricaurte Fajardo, Lysien Zambrano, Alfonso J. Rodriguez-Morales
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