Overlapping Infection by Strongyloides spp. and Cytomegalovirus in the Immunocompromised Host: A Comprehensive Review of the Literature
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Published:2023-07-10
Issue:7
Volume:8
Page:358
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ISSN:2414-6366
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Container-title:Tropical Medicine and Infectious Disease
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language:en
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Short-container-title:TropicalMed
Author:
Lupia Tommaso1ORCID, Crisà Elena2, Gaviraghi Alberto3, Rizzello Barbara3, Di Vincenzo Alessia4, Carnevale-Schianca Fabrizio2, Caravelli Daniela2, Fizzotti Marco2, Tolomeo Francesco2, Vitolo Umberto2ORCID, De Benedetto Ilaria3, Shbaklo Nour3, Cerutti Alessandro5, Fenu Piero6, Gregorc Vanesa2ORCID, Corcione Silvia37, Ghisetti Valeria4, De Rosa Francesco Giuseppe13ORCID
Affiliation:
1. Unit of Infectious Diseases, Cardinal Massaia, 14100 Asti, Italy 2. Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy 3. Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy 4. Microbiology Unit, Amedeo di Savoia Hospital, 10100 Turin, Italy 5. Intensive Care Unit, IRCCS Candiolo, 10100 Candiolo, Italy 6. Healthcare Management, IRCCS Candiolo, 10100 Candiolo, Italy 7. School of Medicine, Tufts University, Boston, MA 02111, USA
Abstract
Strongyloides and cytomegalovirus co-infections are rarely reported, even though they are distinguished by high morbidity and mortality, especially in immunocompromised hosts. We narratively reviewed the literature on reported cases of Strongyloides and CMV co-infections in immunosuppressed patients. Most cases occurred in males with a median age of 47 (IQR, 37–59). Strongyloides/CMV co-infections occurred among immunocompromised hosts, especially in solid organ transplants and hematological or rheumatological diseases. Most of the patients underwent a course of steroid treatment before the diagnosis of co-infections. Other common immunomodulatory agents were tacrolimus and mycophenolate. The first clinical manifestations of co-infections were mainly gastrointestinal, followed by respiratory symptoms. CMV was, in most patients, co-infected with an isolated reactivation, although Strongyloides manifested especially as hyperinfection syndrome. Ganciclovir and ivermectin are the mainstays of CMV and Strongyloides treatment. However, the treatment mortality reported in this narrative review is around 52.4%. Interestingly secondary bacterial infections are common in CMV/Strongyloides-infected patients.
Subject
Infectious Diseases,Public Health, Environmental and Occupational Health,General Immunology and Microbiology
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