Strongyloides Hyperinfection Syndrome (SHS) in a Patient With Prolonged Intensive Care Unit (ICU) Exposure: A Case Report.

Strongyloides hyperinfection syndrome (SHS) is a severe manifestation of the Strongyloides parasite, often occurring in immunocompromised patients due to the inability to subdue larvae autoinfection. As the parasitic burden increases, the patient can develop worsening respiratory symptoms that mimic common pathologies such as chronic obstructive pulmonary disease (COPD). The parasite is endemic to the Appalachian region as well as subtropical and tropical areas worldwide. Despite millions of cases reported annually, it is not commonly screened for in symptomatic high-risk patients. The mortality rate from SHS is high, and few studies have explored the effects of early Strongyloides screening on reducing mortality. This case report focuses on a 71-year-old male who was diagnosed with SHS after one month of progressive deterioration in the intensive care unit (ICU) from Escherichia coli sepsis and acute respiratory failure. The significance of this case is to highlight the occurrence of SHS in immunocompromised patients and discuss the importance of early Strongyloides screening to mitigate mortality of symptomatic high-risk patients in endemic regions.