Volume 99, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



is the main etiological agent of human strongyloidiasis. Severe strongyloidiasis is commonly associated to alcoholism, corticostereoid use, and human T cell lymphotropic virus type 1 (HTLV-1) coinfection. Herein, we report a case of a 13-year-old boy coinfected with and HTLV-1, excreting several parasitic forms in the stool. The parasitological examination of his feces showed a large amount of filariform (about 3,000 larvae per gram of feces) and rhabditiform larvae (about 2,000 larvae per gram of feces). In addition, free-living adult females (about 50 parasites per gram of feces) and eggs (about 60 eggs per gram of feces) were detected. The main laboratory findings pointed to high immunoglobulin E (IgE) levels (228 UI/mL) and eosinophila (11.6%). The patient was treated with three courses of ivermectin (200 µg/kg twice, 2 weeks apart), achieving the parasitological cure. An increase of about 19 times in interleucin (IL)-17 level was observed following the parasitological cure, in addition to a decrease in the white blood cell, eosinophil counts, and IgE levels. This is the first case report, to our knowledge, in which an adult free-living female was described in human feces and where an increase in IL-17 levels after treatment in a HTLV-1 coinfected individual was observed. This finding raises the need for further studies about IL-17 immunomodulation in and HTLV-1 coinfected patients.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Nutman TB, , 2017. Human infection with Strongyloides stercoralis and other related Strongyloides species. Parasitology 144: 263273. [Google Scholar]
  2. De Souza JN, Machado PR, Teixeira MC, Soares NM, , 2014. Recurrence of Strongyloides stercoralis infection in a patient with Hansen’s disease: a case report. Lepr Rev 85: 5862. [Google Scholar]
  3. Zammarchi L, Montagnani F, Tordini G, Gotuzzo E, Bisoffi Z, Bartoloni A, Luca AD, , 2015. Persistent strongyloidiasis complicated by recurrent meningitis in an HTLV seropositive peruvian migrant resettled in Italy. Am J Trop Med Hyg 92: 12571260. [Google Scholar]
  4. Willems L, 2017. Reducing the global burden of HTLV-1 infection: an agenda for research and action. Antiviral Res 137: 4148. [Google Scholar]
  5. Carvalho EM, Da Fonseca Porto A, , 2004. Epidemiological and clinical interaction between HTLV-1 and Strongyloides stercoralis. Parasite Immunol 26: 487497. [Google Scholar]
  6. Porto MAF, Muniz A, Oliveira Júnior J, Carvalho EM, , 2002. Clinical and immunological consequences of the association between HTLV-1 and strongyloidiasis. Rev Soc Bras Med Trop 35: 641649. [Google Scholar]
  7. Cabral AC, Iñiguez AM, Moreno T, Bóia MN, Carvalho-Costa FA, Cabral AC, Iñiguez AM, Moreno T, Bóia MN, Carvalho-Costa FA, , 2015. Clinical conditions associated withintestinal strongyloidiasis in Rio de Janeiro, Brazil. Rev Soc Bras Med Trop 48: 321325. [Google Scholar]
  8. 2016. Association between Strongyloides stercoralis infection and cortisol secretion in alcoholic patients. Acta Trop 154: 133138. [Google Scholar]
  9. Viney M, , 2017. Strongyloides. Parasitology 144: 259262. [Google Scholar]
  10. Porto AF, Neva FA, Bittencourt H, Lisboa W, Thompson R, Alcântara L, Carvalho EM, , 2001. HTLV-1 decreases Th2 type of immune response in patients with strongyloidiasis. Parasite Immunol 23: 503507. [Google Scholar]
  11. Weatherhead JE, Mejia R, , 2014. Immune response to infection with Strongyloides stercoralis in patients with infection and hyperinfection. Curr Trop Med Rep 1: 229233. [Google Scholar]
  12. de Souza JN, Teixeira MCA, Soares NM, , 2015. Associação entre hiperinfecção por Strongyloides stercoralis e HTLV-1: um relato de caso. Rev Ciênc Médicas E Biológicas 13: 427430. [Google Scholar]
  13. Negrão-Corrêa D, , 2001. Importance of immunoglobulin E (IgE) in the protective mechanism against gastrointestinal nematode infection: looking at the intestinal mucosae. Rev Inst Med Trop São Paulo 43: 291299. [Google Scholar]
  14. Silva MLS, 2017. Influence of parasite load on the diagnosis and occurrence of eosinophilia in alcoholic patients infected with Strongyloides stercoralis. J Helminthol 28: 15. [Google Scholar]
  15. Domingos JA, Soares LS, Bandeira LM, Bonin CM, Vicente ACP, Zanella L, Puga MAM, Tozetti IA, Motta-Castro ARC, Cunha RV, , 2017. Cytokine profile and proviral load among Japanese immigrants and non-Japanese infected with HTLV-1 in a non-endemic area of Brazil. PLoS One 12: e0174869. [Google Scholar]
  16. Dodon MD, Li Z, Hamaia S, Gazzolo L, , 2004. Tax protein of human T-cell leukaemia virus type 1 induces interleukin 17 gene expression in T cells. J Gen Virol 85: 19211932. [Google Scholar]
  17. Santos SB, Oliveira P, Luna T, Souza A, Nascimento M, Siqueira I, Tanajura D, Muniz AL, Glesby MJ, Carvalho EM, , 2012. Immunological and viral features in patients with overactive bladder associated with human T-cell lymphotropic virus type 1 infection. J Med Virol 84: 18091817. [Google Scholar]
  18. Leal FE, 2013. Expansion in CD39+ CD4+ immunoregulatory t cells and rarity of Th17 cells in HTLV-1 infected patients is associated with neurological complications. PLoS Negl Trop Dis 7: e2028. [Google Scholar]
  19. Barrett J, Broderick C, Soulsby H, Wade P, Newsholme W, , 2016. Subcutaneous ivermectin use in the treatment of severe Strongyloides stercoralis infection: two case reports and a discussion of the literature. J Antimicrob Chemother 71: 220225. [Google Scholar]
  20. Bisoffi Z, Buonfrate D, Angheben A, Boscolo M, Anselmi M, Marocco S, Monteiro G, Gobbo M, Bisoffi G, Gobbi F, , 2011. Randomized clinical trial on ivermectin versus thiabendazole for the treatment of strongyloidiasis. PLoS Negl Trop Dis 5: e1254. [Google Scholar]
  21. Suputtamongkol Y, Premasathian N, Bhumimuang K, Waywa D, Nilganuwong S, Karuphong E, Anekthananon T, Wanachiwanawin D, Silpasakorn S, , 2011. Efficacy and safety of single and double doses of ivermectin versus 7-day high dose albendazole for chronic strongyloidiasis. PLoS Negl Trop Dis 5: e1044. [Google Scholar]
  22. Zaha O, Hirata T, Kinjo F, Saito A, Fukuhara H, , 2002. Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart. J Infect Chemother 8: 9498. [Google Scholar]
  23. Zaha O, Hirata T, Uchima N, Kinjo F, Saito A, , 2004. Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody. J Infect Chemother 10: 348351. [Google Scholar]
  24. Kinjo T, Nabeya D, Nakamura H, Haranaga S, Hirata T, Nakamoto T, Atsumi E, Fuchigami T, Aoki Y, Fujita J, , 2015. Acute respiratory distress syndrome due to Strongyloides stercoralis infection in a patient with cervical cancer. Intern Med Tokyo Jpn 54: 8387. [Google Scholar]

Data & Media loading...

  • Received : 11 May 2018
  • Accepted : 19 Aug 2018
  • Published online : 01 Oct 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error