Overlapping Infection by <i>Strongyloides</i> spp. and Cytomegalovirus in the Immunocompromised Host: A Comprehensive Review of the Literature

<i>Strongyloides</i> 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 <i>Strongyloides</i> and CMV co-i...

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Main Authors: Tommaso Lupia, Elena Crisà, Alberto Gaviraghi, Barbara Rizzello, Alessia Di Vincenzo, Fabrizio Carnevale-Schianca, Daniela Caravelli, Marco Fizzotti, Francesco Tolomeo, Umberto Vitolo, Ilaria De Benedetto, Nour Shbaklo, Alessandro Cerutti, Piero Fenu, Vanesa Gregorc, Silvia Corcione, Valeria Ghisetti, Francesco Giuseppe De Rosa
Format: Article
Language:English
Published: MDPI AG 2023-07-01
Series:Tropical Medicine and Infectious Disease
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Online Access:https://www.mdpi.com/2414-6366/8/7/358
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Summary:<i>Strongyloides</i> 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 <i>Strongyloides</i> and CMV co-infections in immunosuppressed patients. Most cases occurred in males with a median age of 47 (IQR, 37–59). <i>Strongyloides</i>/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 <i>Strongyloides</i> manifested especially as hyperinfection syndrome. Ganciclovir and ivermectin are the mainstays of CMV and <i>Strongyloides</i> treatment. However, the treatment mortality reported in this narrative review is around 52.4%. Interestingly secondary bacterial infections are common in CMV/<i>Strongyloides</i>-infected patients.
ISSN:2414-6366