Strongyloides stercoralis hyperinfection

Strongyloides stercoralis (Ss) is an endemic nematode in tropical and subtropical countries. Cases have also been described in Spain, major mainly in the Mediterranean coast. Ss infection is usually asymptomatic or causes mild gastrointestinal symptoms. Spillover infection can cause widespread disseminated strongylodiasis associated to severe systemic bacterial infections which may lead to multiorgan failure and death. The most important risk factors that may convert an infection that is basically intestinal and often asymptomatic, to severe entity, are immunocompromised conditions and corticosteroids therapy, due to their effect on the eosinophil function. We report a case of a patient affected by Crohn's disease in chronic treatment with corticosteroids who developed a Ss hyperinfective condition with pulmonary involvement leading to bilateral pneumonia and acute respiratory distress syndrome (ARDS). The study of stool, sputum and gastric content samples confirmed the presence of the parasite. (C) 2009 Elsevier Espana, S.L. and SEMICYUC. All rights reserved.