Respiratory Failure Due to Strongyloides stercoralis Hyperinfection: A Case Report of a Neglected Tropical Disease

TL;DR

A 25-year-old man developed severe respiratory failure from a rare parasitic infection, highlighting the importance of considering Strongyloides stercoralis in cases with unexplained symptoms and high eosinophilia.

Contribution

This case emphasizes the need to consider S. stercoralis hyperinfection in patients with respiratory failure and eosinophilia.

Findings

The patient was diagnosed with S. stercoralis hyperinfection after presenting with respiratory failure and marked eosinophilia.

Microscopic examination of the endotracheal aspirate confirmed the presence of Strongyloides stercoralis.

The case underscores the importance of timely diagnostic testing for neglected tropical diseases in critical care.

Abstract

We report the case of a 25-year-old male patient admitted to the intensive care unit due to respiratory failure. The patient presented to the Emergency Department with shortness of breath, productive cough, and fever and was initially treated empirically for suspected community-acquired pneumonia of bacterial origin. Despite treatment, his condition worsened, necessitating invasive mechanical ventilation. Laboratory investigations revealed marked eosinophilia, prompting microbiological examinations.

Strongyloides stercoralis was detected on microscopic examination of the endotracheal aspirate. The patient was subsequently diagnosed with eosinophilic pneumonia due to an S. stercoralis hyperinfection. Although S. stercoralis hyperinfection is often an overlooked cause of severe respiratory failure, it should be considered in patients with marked eosinophilia, particularly when accompanied by epidemiological risk factors. Appropriate and timely utilization of diagnostic testing is essential to establish the correct diagnosis.

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