CTICasesStrongyloides Hyperinfection Syndrome with Pneumocystis Pneumonia
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Imaging findings
Abdominal CT reveals markedly thickened loops of jejunum. Chest CT shows diffuse ground-glass opacities with a prominent miliary pattern of tiny nodules throughout the lungs. Subsequent imaging after treatment demonstrates some pulmonary improvement.
Key takeaways
Strongyloides hyperinfection syndrome is a severe, life-threatening complication occurring in immunocompromised individuals, such as organ transplant recipients. It involves accelerated autoinfection and dissemination of larvae. Key clinical features include abdominal pain, diarrhea, a petechial rash, and profound pulmonary involvement. Imaging findings include diffuse jejunal thickening and a diffuse miliary nodular pattern in the lungs, often superimposed on ground-glass opacities. Co-infection with other opportunistic pathogens, such as Pneumocystis pneumonia (PCP), is common in these immunosuppressed patients.
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