Epidemiological and clinical profile of immunosuppressed patients with imported strongyloidiasis: a substudy from a larger cohort of the +REDIVI Spanish Collaborative Network.

ABSTRACT

The aim of this study was to describe the clinical and epidemiological profile of immunosuppressed patients with imported strongyloidiasis in a non-endemic setting, and to compare these results with non-immunosuppressed patients. This is a case-control substudy from a larger observational retrospective study that included all patients with strongyloidiasis registered in the +REDIVI Spanish Collaborative Network. Overall, 1245 patients with imported strongyloidiasis were included. From these, 80 (6.4%) patients had some kind of immunosuppression. Three (3.8%) patients had a hyperinfection syndrome, and 34 (52.3%) patients had eosinophilia. The percentages of positive results of the formalin-ether technique, the fecal culture and serology were 12.3%, 21.1% and 95.4%, respectively. When comparing the main characteristics, immunosuppressed patients had higher proportion of severe clinical manifestations and lower proportion of eosinophilia. No differences were found regarding yield of microbiological techniques and treatment response. These results stress the importance of strongyloidiasis screening among immunosuppressed patients coming from endemic areas. Serological tests have an acceptable sensitivity to be used as a screening tool.

KEYWORDS:

• Strongyloides stercoralis
• strongyloidiasis
• immunosuppression
• HIV

Acknowledgments

This study was supported by the ISCIII-Collaborative Research Network on Tropical Diseases (RICET) and the European Regional Development Fund (ERDF): RD16/0027/0003 and RD16/0027/0020.

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Disclosure statement

The authors declare that they have no competing interests.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.