{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T14:35:24Z","timestamp":1762353324759,"version":"build-2065373602"},"reference-count":17,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Strongyloides stercoralis<\/jats:italic>\n                    is a soil-transmitted nematode that leads to asymptomatic or mild infections in immunocompetent hosts; however, in immunocompromised individuals, it can lead to hyperinfection and disseminated strongyloidiasis that can be fatal. Central nervous system (CNS) involvement is rare but can result in severe complications, such as meningitis. Diagnosis is challenging because of the low sensitivity of conventional microscopy. Molecular techniques, such as quantitative polymerase chain reaction (qPCR), are more sensitive, especially for detecting\n                    <jats:italic>S. stercoralis<\/jats:italic>\n                    in cerebrospinal fluid (CSF). We report a case of a 28-year-old female with newly diagnosed advanced HIV infection with CD4 counts of 54 cells\/\n                    <jats:italic>\u00b5<\/jats:italic>\n                    L presenting with disseminated strongyloidiasis and CNS involvement. She subsequently developed\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    bacteremia and meningitis. Although microscopy of stool and sputum detected the infection,\n                    <jats:italic>S. stercoralis<\/jats:italic>\n                    qPCR in CSF was crucial for diagnosing CNS involvement. This case underscores the importance of molecular diagnosis of CNS strongyloidiasis among high-risk patients to enable timely appropriate therapeutic intervention.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0202","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T15:46:14Z","timestamp":1758642374000},"page":"1035-1038","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis of Central Nervous System Strongyloidiasis in a Patient with Advanced Human Immunodeficiency Infection with Quantitative Polymerase Chain Reaction: Improving Detection and Clinical Management"],"prefix":"10.4269","volume":"113","author":[{"given":"Ramya","family":"Madhavan","sequence":"first","affiliation":[{"name":"The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selwyn","family":"Selva Kumar","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Christian Medical College, Vellore, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malathi","family":"Manuel","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selvi","family":"Laxmanan","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harshad","family":"Arvind Vanjare","sequence":"additional","affiliation":[{"name":"Department of Radiology, Christian Medical College, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abi","family":"Manesh","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Christian Medical College, Vellore, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sitara Swarna Rao","family":"Ajjampur","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Cureus","first-page":"e46908","article-title":"Strongyloides stercoralis infection in humans: A narrative review of the most neglected parasitic disease","volume":"15","author":"Yeh","year":"2023"},{"key":"b2","series-title":"Clin Microbiol Rev","first-page":"208","article-title":"Strongyloides stercoralis in the immunocompromised population","volume":"17","author":"Keiser","year":"2004"},{"key":"b3","series-title":"Southeast Asian J Trop Med Public Health","first-page":"875","article-title":"Risk factors for strongyloidiasis hyperinfection and clinical outcomes","volume":"37","author":"Asdamongkol","year":"2006"},{"key":"b4","series-title":"Parasitology","first-page":"263","article-title":"Human infection with Strongyloides stercoralis and other related Strongyloides species","volume":"144","author":"Nutman","year":"2017"},{"key":"b5","series-title":"Ann Indian Acad Neurol","first-page":"234","article-title":"Disseminated strongyloidiasis: Breaking brain barriers","volume":"22","author":"Sebastian","year":"2019"},{"key":"b6","series-title":"PLoS Negl Trop Dis","first-page":"e0004578","article-title":"Improved PCR-based detection of soil transmitted helminth infections using a next-generation sequencing approach to assay design","volume":"10","author":"Pilotte","year":"2016"},{"year":"2025","key":"b7","article-title":"NACO Updates."},{"key":"b8","series-title":"Indian J Dermatol Venereol Leprol","first-page":"709","article-title":"Prevention of Strongyloides stercoralis hyperinfection in leprosy patients on long-term steroid therapy","volume":"84","author":"Prabha","year":"2018"},{"key":"b9","series-title":"Clin Chim Acta","first-page":"120184","article-title":"Molecular detection of Strongyloides stercoralis: Emerging factors and diagnostic utility","volume":"569","author":"Zainol","year":"2025"},{"key":"b10","series-title":"Indian J Med Microbiol","first-page":"147","article-title":"Risk factors for acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in south India","volume":"29","author":"Chordia","year":"2011"},{"key":"b11","series-title":"J Pharm Bioallied Sci","first-page":"102","article-title":"Eosinophilia in advanced HIV infection with hyperinfection syndrome: A case report","volume":"10","author":"Gupta","year":"2018"},{"key":"b12","series-title":"Diagn Microbiol Infect Dis","first-page":"197","article-title":"Real-time PCR for Strongyloides stercoralis\u2013associated meningitis","volume":"84","author":"Nadir","year":"2016"},{"key":"b13","series-title":"PLoS Negl Trop Dis","first-page":"e1581","article-title":"Is human immunodeficiency virus infection a risk factor for Strongyloides stercoralis hyperinfection and dissemination","volume":"6","author":"Siegel","year":"2012"},{"key":"b14","series-title":"Am J Case Rep","first-page":"339","article-title":"Strongyloides stercoralis infection among human immunodeficiency virus (HIV)-infected patients in the United States of America: A case report and review of literature","volume":"18","author":"Vazquez Guillamet","year":"2017"},{"key":"b15","series-title":"Lancet Infect Dis","first-page":"e601","article-title":"Strongyloides stercoralis hyperinfection syndrome","volume":"24","author":"Jacob","year":"2024"},{"key":"b16","series-title":"Am J Trop Med Hyg","first-page":"911","article-title":"Parenteral administration of ivermectin in a patient with disseminated strongyloidiasis","volume":"73","author":"Turner","year":"2005"},{"key":"b17","series-title":"BMJ Case Rep","first-page":"bcr2017223138","article-title":"Successful use of subcutaneous ivermectin for the treatment of Strongyloides stercoralis hyperinfection in the setting of small bowel obstruction and paralytic ileus in the immunocompromised population","volume":"2018","author":"Zeitler","year":"2018"}],"container-title":["The American Journal of Tropical Medicine and 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