AUTHOR=Xu Qinfu , Xi Xiaotong , Feng Dan , Sang Qian , Sheng Yanbing , Ding Ran , Xu Aiguo 

TITLE=A case report: Severe disseminated infection caused by Strongyloides stercoralis in an immunocompromised patient by metagenomic next-generation sequencing

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1082412

DOI=10.3389/fcimb.2023.1082412

ISSN=2235-2988

ABSTRACT=<sec><title>Background</title><p><italic>Strongyloides stercoralis</italic> (<italic>S. stercoralis</italic>) is a nematode that is widely distributed in the tropical and subtropical regions of the world and which can cause severe disseminated infection in immunocompromised individuals. However, strongyloidiasis, the disease caused by <italic>S. stercoralis</italic>, is difficult to diagnose because of its non-specific clinical presentation and the inadequate performance of conventional diagnostic methods.</p></sec><sec><title>Case description</title><p>We report the case of a 75-year-old male patient with severe disseminated infection caused by <italic>S. stercoralis</italic>. The patient had a medical history of seasonal bronchitis and, as a consequence, had taken prednisone for many years. Initial clinical tests failed to detect any pathogens, but metagenomic next-generation sequencing (mNGS) resulted in the identification of <italic>S. stercoralis</italic> in the patient’s bronchoalveolar lavage fluid (BALF) and blood. Subsequently, routine testing repeatedly detected nematode larvae in the patient’s stool and sputum. Through a combination of mNGS results and clinical symptoms, the patient was finally diagnosed with severe disseminated infection caused by <italic>S. stercoralis</italic>.</p></sec><sec><title>Conclusion</title><p>The clinical manifestations of disease caused by infection with <italic>S. stercoralis</italic> are not specific; therefore, early and accurate diagnosis is very important. mNGS can detect <italic>S. stercoralis</italic> even when it is present at only a low level. This case report supports the notion that mNGS is a valuable tool in the diagnosis of severe disseminated infections caused by <italic>S. stercoralis</italic> in immunocompromised patients.</p></sec>