Annals of Indian Academy of Neurology
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Year : 2019  |  Volume : 22  |  Issue : 2  |  Page : 234-237

Disseminated strongyloidiasis: Breaking brain barriers

1 Department of Neurology, Christian Medical College, Ludhiana, Punjab, India
2 Department of Microbiology, Christian Medical College, Ludhiana, Punjab, India
3 Department of Infectious Diseases, Wayne State School of Medicine, Detroit, Michigan, USA

Correspondence Address:
Dr. Jeyaraj Durai Pandian
Department of Neurology, Christian Medical College and Hospital, Ludhiana, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.AIAN_321_18

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Strongyloides stercoralis (SS) is one of the most overlooked helminthic infections despite being highly endemic in tropical and subtropical areas. In immunocompromised patients, especially those on long-term steroids, infection can often escalate to fatal dissemination into major organs. We present a compendium of two immunocompromised patients, who were on high-dose steroids and presented with worsening neurological status. Cerebrospinal fluid analysis was notable for larvae of SS as diagnosed by direct visualization. A syndrome of SS hyperinfection with dissemination was made after stool, and sputum samples also revealed SS larvae. SS is an elusive disease and should be considered early on, especially in endemic regions like India. Early diagnosis and prompt initiation of antihelminthic therapy is indispensable for favorable outcomes.

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