Figure - available from: Case Reports in Critical Care
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Histological examination showing Strongyloides stercoralis larvae. (a) Duodenal biopsy: duodenal crypts distended by numerous larvae and adult worms. (b) Purpuric lesion transcutaneous biopsy: deep dermis location of filariform larvae between collagen bundles. (c) Bronchoalveolar aspiration: inflammation and filariform larvae.
Source publication
Because of its characteristic features of autoinfection, the parasitic nematode Strongyloides stercoralis can infect patients for years. An acceleration of its autoinfective cycle can be triggered by human T-lymphotropic virus-1 (HTLV-1) infection, mainly by the deviation of the protective Th2- to Th1-type immune response and can lead to severe dis...
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Background
The distribution of human T cell lymphotropic virus type 1 (HTLV-1) overlaps with that of Strongyloides stercoralis . Strongyloides stercoralis infection has been reported to be impacted by co-infection with HTLV-1. Disseminated strongyloidiasis and hyperinfection syndrome, which are commonly fatal, are observed in HTLV-1 co-infected pat...
Citations
... The situation is further compounded by the future prospect of S. stercoralis resistance due to repeated mass drug administrations as part of control programs for onchocerciasis or lymphatic filariasis elimination. Thus, the development of alternative treatment options to ivermectin that serve as additions to the depleted drug armamentarium are urgently needed [65]. Table 4. Drugs used in the treatment of HTLV-1-associated strongyloidiasis. ...
... Both cases were treated with ivermectin 200 mcg/kg, and only one patient received auxiliary treatment with albendazole 400 mg per day. Unfortunately, in both cases, the outcome was death, maybe due to disseminated infection and late diagnosis, highlighting that patients with HTLV-1 are more likely to develop severe strongyloidiasis and failure in treatment with anthelmintic drugs (Table 4) [65,66]. Hunter et al. (2019) reports the clinical case of a man residing in an Argentine province who reported diarrhea, abdominal pain, and weight loss in recent months. ...
Among the human T-lymphotropic virus (HTLV) types, HTLV-1 is the most prevalent, and it has been linked to a spectrum of diseases, including HAM/TSP, ATLL, and hyperinfection syndrome or disseminated strongyloidiasis. There is currently no globally standard first-line treatment for HTLV-1 infection and its related diseases. To address this, a comprehensive review was conducted, analyzing 30 recent papers from databases PubMed, CAPES journals, and the Virtual Health Library (VHL). The studies encompassed a wide range of therapeutic approaches, including antiretrovirals, immunomodulators, antineoplastics, amino acids, antiparasitics, and even natural products and plant extracts. Notably, the category with the highest number of articles was related to drugs for the treatment of ATLL. Studies employing mogamulizumab as a new perspective for ATLL received greater attention in the last 5 years, demonstrating efficacy, safe use in the elderly, significant antitumor activity, and increased survival time for refractory patients. Concerning HAM/TSP, despite corticosteroid being recommended, a more randomized clinical trial is needed to support treatment other than corticoids. The study also included a comprehensive review of the drugs used to treat disseminated strongyloidiasis in co-infection with HTLV-1, including their administration form, in order to emphasize gaps and facilitate the development of other studies aiming at better-directed methodologies. Additionally, docking molecules and computer simulations show promise in identifying novel therapeutic targets and repurposing existing drugs. These advances are crucial in developing more effective and targeted treatments against HTLV-1 and its related diseases.
