The Deadly Dangers Of The Intestinal Parasite, Strongyloides.
Study published: Clinical and Molecular Allergy 2006, 4:8
By: Dr. Walter K. Crooks
October 13, 2012
Strongyloides are tiny parasitic worms that like to dine on humans.
People with Strongyloidiasis have the worms until they die, unless they receive effective treatment. The worm may persist for 40 years or more in the small intestine, and it can also be spread as a sexually transmitted disease.
Stronglyoidiasis is fairly common in America, however it is not often diagnosed because, if chronic, the symptoms are mostly mild or mistaken for some other disease process. In a great many instances, people found infested with strongyloides have usually been infested for years, even decades before being diagnosed and treated.
An infection of strongyloides can be difficult to eradicate completely mainly because of the specialized ability of these worms to autoinfect their host.
Strongyloides are unique and dangerous because of the following specialized characteristic features they employ:
1. Autoinfection: This is an important characteristic feature of this worms life cycle. Upon penetrating the intestinal wall or skin around the anus, the larvae enter the bloodstream and reach the pulmonary circulation.
They then penetrate into the lung tissue’s membrane so that they may do one of two things:
a) Become airborne to infect others.
b) Travel up the bronchial tree, causing irritation, which in turn causes the infected person to cough thus allowing for the larva to be swallowed into the gastrointestinal tract to begin the infection process all over again.
2. Hyper-infection: The hyper-infection syndrome happens when there is an enormous multiplication and migration of infective larvae. This especially happens to a person that is in an immunosuppressed state, such as patients that are on long-term corticosteroids.
Symptoms include mainly asthma-like complaints such as cough and wheezing, along with possible pneumonia and pulmonary hemorrhage.
Rare conditions like eosinophilic pleural effusions and eosinophilic granulomatous enterocolitis have also been reported in strongyloidiasis.
One factor that has been attributed to these sudden parasite population explosions is the chronic use of immunosuppressive drugs like, systemic corticosteroids (cortisol, hydrocortisone), organ transplants and other infections such as kala-azar.
3. Disseminated Infection: In patients that are taking immunosuppressant drugs such as exogenous cortisol (hydrocortisone), Fatal Disseminated Infections are known to occur.
In patients that are malnourished or have been victims of chronic infections, there is an 87% chance of death with this infection.
The high mortality rate associated with hyper-infection syndrome and disseminated diseases are frequently due to a secondary bacterial infection.
Corticosteroids and Strongyloidiasis
Multiple case reports indicate a potential increase in the frequency of fatal hyper-infection or disseminated infection with corticosteroid therapy in patients with asymptomatic or mild strongyloidiasis.
Corticosteroids have been shown to affect a patients immunity by increasing the apoptosis (programed cell death) of immune system Th2 cells, reducing the eosinophil count and inhibiting the mast cell response which leads to hyperinfection or disseminated infection.
It is also believed that corticosteroid therapy increases ecdysteroid like substances (these are naturally occurring sterols with non-hormonal anabolic effects) in the body, mainly in the intestinal wall.
Unfortunately, when these steroids are in the presence of the stronglyoides worm they produce substances that act as a molting (reproduction) signal to the larvae, which leads to hyperinfection and disseminated infections.
Research conducted by Siddiqui et al., has found that there are corticosteroid receptors on Strongyloides. These receptors could also play a role in hyperinfection syndrome along with the systemic disseminated infection associated with corticosteroids.
Strongyloidiasis is a nematode infection with a tendency to become chronic with fatal complications of hyperinfection syndrome and disseminated infection along with a host of other potential complications like gram-negative bacteremia and meningitis.
Due to the fact that most cases of hyperinfection syndrome and disseminated strongyloidiasis happen in immuno-compromised individuals, especially those who are taking systemic corticosteroids, like hydrocortisone, physicians should be aware of the bizarre manifestations of the disease that can mimic other diseases leading to misdiagnosis and medical errors.
If you or someone you know are infected with the Strongyloides nematode and are taking corticosteroides (hydrocortisone, ect. ), it is imperative that you speak to your physician at once and ask that they review the facts associated with Strongyloidiasis and hydrocortisone therapy.
Dr. Walter K. Crooks