3 Cases of Systemic Strongyloides in Human Immunodeficiency Virus-Infected Patients

Strongyloides stercolaris is an intestinal nematode that is endemic in tropical and subtropical areas. In immunocompromised individuals such as individuals with human T-lymphotrophic virus 1 or history of corticosteroid use, Strongyloides (SS) infection can accelerate to hyperinfection or disseminated infection, conditions which are associated with high mortality. Human immunodeficiency virus (HIV) is not considered to be a risk factor for systemic SS infection; however, dozens of cases of HIV patients that have developed SS in the absence of recognized risk factors have been described in the literature. Although the burden of SS in HIV patients is not as high as would be expected if HIV was an equivalent risk factor to human T-lymphotrophic virus 1 or steroid usage, the number of reported cases indicates that there may be a relationship between HIV and SS. We report 3 additional cases of HIV patients with SS infections that presented at a major metropolitan county hospital in Houston, Tex.