Hiperinfección por Strongyloides stercoralis en portadores del viru linfotrópico humano tipoI (HTLV-I)

Abstract

Seven patients carrying Human T-cell lymphotropic virus type I (HTLV-I) suffering S. stercoralis hyperinfection are reported. None of them were affected with tropical spastic paraparesis/ HTLV-I associated myelopathy (TSP/HAM) or adult T-cell leukemia/ lymphoma (ALT). Immunosupresive therapy was not given to them, including steroids. They did not receive blood transfusions previously. HTLV-I infection was determined by ELISA or PA, and confirmed with Western blot. They were HIV seronegative. S. stercoralis was detected in stool using Baerman test in 6/7, and in all of them in gastric and/or duodenal biopsy.

Six of them were born at the pacific coast, and the remainder was born in Bucaramanga, Santander. Progressive abdominal pain, loss of appetite, nausea, vomiting and diarrhea were common symptoms. Chronic gastritis and duodenitis were found. Four of them showed gastric infiltration by S. stercoralis. Severe malnutrition and lack of eosinophilia were also noticed.

Among complications, a case of bacterial meningitis, a case of brain abscess, and a case of Gram negative sepsis were observed. In summary, HTLV-I carriers are prone to develop a selective immunosupression against S. stercoralis. We suggest that it is necessary to search for HTLV-I coinfection in S. stercoralis hyperinfection.