# Respiratory Manifestations of Strongyloidiasis: Significance of Diagnosis, Treatment, and Screening

## TL;DR

A case study highlights how strongyloidiasis can lead to severe respiratory and gastrointestinal complications in high-risk patients.

## Contribution

The paper emphasizes the importance of screening for parasitic infections in high-risk and immunocompromised individuals with respiratory and gastrointestinal symptoms.

## Key findings

- Strongyloidiasis can progress to hyperinfection syndrome, causing severe respiratory and gastrointestinal symptoms.
- Antiparasitic treatment significantly improved the patient's condition after diagnosis.
- Community-acquired pneumonia can be complicated by reactivated strongyloidiasis in high-risk patients.

## Abstract

Strongyloidiasis is a widespread disease characterized clinically by acute or chronic manifestations, which, in high-risk individuals and immunocompromised individuals, can progress to hyperinfection syndrome and disseminated forms with significant mortality rates. Among extraintestinal organs, the lungs are most commonly affected. Clinical presentations are very diverse, contributing to the challenges of diagnosis and timely treatment initiation. We present the case of a 57-year-old patient who was admitted to the intensive care unit (ICU) due to bilateral pneumonia and septic shock. During a two-month hospitalization period, the patient spent 16 days on invasive mechanical ventilation. Initially, nonspecific symptoms, such as weakness, fatigue, and cough, evolved into complications, including diarrheal syndrome, hemoptysis, urticaria, and ventilator-associated pneumonia (VAP) caused by Gram-negative bacteria. Numerous larvae of Strongyloides stercoralis were identified in a stool sample. In addition to antibiotic therapy, antiparasitic treatment was administered, resulting in significant improvement in the patient's overall condition, leading to discharge for further home care. In this case, community-acquired pneumonia was complicated by the reactivation of chronic strongyloidiasis in the form of hyperinfection syndrome in a high-risk patient. High-risk individuals and immunocompromised individuals should undergo screening for parasitic infections in cases presenting with gastrointestinal symptoms, particularly diarrhea and respiratory symptoms. Screening for parasitic infections should be integrated into routine clinical practice for this population.