Hyperinfection involves increased signs and symptoms involving the gastrointestinal and respiratory systems caused by increased larval migrations.
Disseminated strongyloidiasis involves signs and symptoms associated with migration of the larvae into extraintestinal and extrapulmonary organs.
Findings in hyperinfection:
(1) intestinal obstruction
(2) ileus
(3) significant GI bleeding
(4) increased abdominal pain
(5) increased nausea, vomiting, diarrhea or anorexia
(6) steatorrhea or malabsorption
(7) weight loss
(8) inflammation anywhere along the GI tract (esophagitis, gastritis, duodenitis, jejunitis, ileitis, appendicitis, colitis, proctitis)
(9) exacerbation of asthmatic symptoms
(10) increased cough and dyspnea
(11) hemoptysis
(12) adult respiratory distress syndrome
(13) recurrent bronchopneumonia
(14) gram negative bacteremia
(15) large numbers of larvae in stool or larvae present in sputum
Findings in disseminated disease:
(1) fatigue and weakness
(2) generalized body pain
(3) gastrointestinal symptoms as for hyperinfection (above)
(4) protein losing enteropathy with hypoalbuminemia
(5) respiratory symptoms as for hyperinfection (above)
(6) chest pain
(7) pleural effusion
(8) extensive larva currens
(9) gram negative bacteremia
(10) DIC with purpura or petechiae
(11) obstructive jaundice
(12) pancreatitis
(13) myalgias
(14) neurologic findings (headache, altered mental status, meningismus, hemiparesis)
(15) bacterial meningitis
(16) anemia
(17) nephrotic syndrome
(18) seronegative reactive polyarthritis
(19) abundant larvae in stool with occasionally eggs or adults
(20) adult worms may develop in the lungs, with rhabditiform larvae and eggs found in the sputum
(21) larvae found in extraintestinal and extrapulmonary sites
