{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:39:23Z","timestamp":1792269563786,"version":"4.4.0"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Strongyloides stercoralis<\/jats:italic>\n                    is an intestinal nematode endemic in tropical and subtropical regions, capable of persisting for decades through an auto-infective life cycle. In immuno-compromised hosts, particularly those receiving corticosteroids, accelerated auto-infection can result in a hyperinfection syndrome characterised by massive larval proliferation, dissemination and life-threatening secondary bacterial or fungal infections. We report a known alcoholic with chronic steroid exposure who presented with pulmonary and gastrointestinal manifestations of hyperinfection, with larvae detected both in sputum and stool. His course was complicated by multidrug-resistant\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    bacteraemia, probable invasive pulmonary aspergillosis and osmotic demyelination syndrome related to severe electrolyte disturbances. He improved with ivermectin and supportive therapy, highlighting the importance of early recognition of strongyloidiasis in steroid-exposed patients in endemic regions.\n                  <\/jats:p>","DOI":"10.1177\/00494755261487768","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T03:08:38Z","timestamp":1789700918000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Strongyloides hyperinfection complicated by invasive aspergillosis and osmotic demyelination syndrome"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-3640","authenticated-orcid":false,"given":"Sayan","family":"Maharatna","sequence":"first","affiliation":[{"name":"Senior Resident, Infectious Diseases, All India Institute of Medical Sciences, Kalyani, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryalekhshmi","family":"P","sequence":"additional","affiliation":[{"name":"Junior Resident, Department of Microbiology, All India Institute of Medical Sciences, Kalyani, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debanjan","family":"Nandi","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Radiology, All India Institute of Medical Sciences, Kalyani, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nonika","family":"Rajkumari","sequence":"additional","affiliation":[{"name":"Additional Professor, Department of Microbiology, All India Institute of Medical Sciences, Kalyani, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiv Sekhar","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Additional Professor, Department of Microbiology, All India Institute of Medical Sciences, Kalyani, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2912-4958","authenticated-orcid":false,"given":"Sayantan","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Additional Professor, Department of Microbiology, All India Institute of Medical Sciences, Kalyani, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-021-00827-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0031182016000834"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002288"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.17.1.208-217.2004"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/0256-4947.55172"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.1989.4.2.165"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12639-019-01090-x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-78"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2807.220198"},{"key":"e_1_3_2_11_2","volume-title":"Management of Strongyloidiasis. World gastroenterology Organisation global guideline","author":"Farthing M","year":"2018","unstructured":"Farthing M, Albonico M, Bisoffi Z, et al. Management of Strongyloidiasis. World gastroenterology Organisation global guideline. World Gastroenterology Organisation, 2018."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e3181d3cd78"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90166-X"},{"key":"e_1_3_2_14_2","first-page":"522","article-title":"The changing face of osmotic demyelination syndrome","volume":"10","author":"Singh TD","year":"2020","unstructured":"Singh TD, Fugate JE, Rabinstein AA. The changing face of osmotic demyelination syndrome. Neurol Clin Pract 2020; 10: 522\u2013529.","journal-title":"Neurol Clin Pract"},{"key":"e_1_3_2_15_2","first-page":"1","article-title":"Evidence-based guidelines for screening and management of Strongyloidiasis in non-endemic countries","volume":"97","author":"Buonfrate D","year":"2017","unstructured":"Buonfrate D, Requena-Mendez A, Angheben A, et al. Evidence-based guidelines for screening and management of Strongyloidiasis in non-endemic countries. PLoS Negl Trop Dis 2017; 97: 1\u20138.","journal-title":"PLoS Negl Trop Dis"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755261487768","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00494755261487768","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755261487768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T07:19:56Z","timestamp":1789888796000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00494755261487768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":14,"alternative-id":["10.1177\/00494755261487768"],"URL":"https:\/\/doi.org\/10.1177\/00494755261487768","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"article-number":"00494755261487768"}}