Strongyloides: a Minireview and Update

Abstract

Strongyloidiasis, typically caused by Strongyloides stercoralis, is a neglected tropical disease that affects 30 to 100 million people worldwide. Despite the commonly asymptomatic nature of the infection, S. stercoralis infection of immunocompromised individuals can be lethal. Infected but asymptomatic immunocompetent individuals can develop hyperinfection or disseminated infection if they experience any significant change in their immune status, and recently, cases have been described following the use of corticosteroids to treat COVID-19-related pneumonia. Definitive diagnosis is established via stool examination for rhabditiform larvae; however, contemporary methods, including serologic and molecular testing, are increasingly used as adjunct tests. Importantly, exposed individuals and those expected to become immunosuppressed should be screened and pre-emptively treated before starting immunosuppressive agents to avoid cases of dissemination and hyperinfection.