CMAJ • August 31, 2004; 171 (5). doi:10.1503/cmaj.1031698.
© 2004 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Synthèse

Complicated and fatal Strongyloides infection in Canadians: risk factors, diagnosis and management

Sue Lim, Kevin Katz, Sigmund Krajden, Milan Fuksa, Jay S. Keystone and Kevin C. Kain

From the Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine (Lim, Keystone, Kain), University of Toronto, Toronto General Hospital– University Health Network (Lim, Katz, Keystone, Kain); the McLaughlin– Rotman Centre for Global Health, University of Toronto (Kain); and the Division of Infectious Diseases, St. Joseph's Health Centre (Krajden, Fuksa), Toronto, Ont.

Correspondence to: Dr. Kevin C. Kain, Tropical Disease Unit, ES 9-412, Toronto General Hospital, 200 Elizabeth St., Toronto ON M5G 2C4

Abstract

STRONGYLOIDIASIS, WHICH IS CAUSED by the nematode Strongyloides stercoralis, is a common and persistent infection, particularly in developing countries. In the setting of compromised cellular immunity, it can result in fulminant dissemination with case-fatality rates of over 70%. The majority of new Canadian immigrants come from countries where Strongyloides is highly endemic; therefore, the burden of Strongyloides may be underappreciated in Canada. Because early diagnosis and therapy can have a marked impact on disease outcome, screening for this infection should be considered mandatory for patients who have a history of travel or residence in a disease-endemic area and risk factors for disseminated disease (e.g., corticosteroid use and human T-lymphotropic virus type I infection).




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