What is the prognosis of strongyloidiasis?

Updated: Jun 20, 2019
  • Author: Pranatharthi Haran Chandrasekar, MBBS, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Acute and chronic strongyloidiasis carry a good prognosis in immunocompetent hosts. However, untreated infection can persist for the remainder of the patient's life because of autoinfection. Most immunocompetent individuals who develop strongyloidiasis have asymptomatic chronic infections that result in negligible morbidity. A patient's prolonged absence from an endemic area is no guarantee of freedom from infection.

Severe strongyloidiasis (hyperinfection syndrome and disseminated strongyloidiasis) carries a high mortality rate (up to 80%) because the diagnosis is often delayed. This relates to its nonspecific presentation and the host's immunocompromised status. Death from Strongyloides infection is typically iatrogenic and frequently occurs after an asymptomatic infected person is treated with immunosuppression. [32] Gram-negative sepsis is a common consequence of hyperinfection and carries a 50% mortality rate. [33] Disseminated strongyloidiasis may be relatively common in high-risk populations and may be frequently misdiagnosed as isolated gram-negative sepsis or acute respiratory distress syndrome.

(See Complications under Clinical.)


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