CENTRAL-NERVOUS-SYSTEM STRONGYLOIDES-STERCORALIS IN ACQUIRED-IMMUNODEFICIENCY-SYNDROME - A REPORT OF 2 CASES AND REVIEW OF THE LITERATURE

Hyperinfection with Strongyloides stercoralis is rare in acquired immu nodeficiency syndrome (AIDS), despite endemicity in areas where infect ion with human immunodeficiency virus is highly prevalent. We autopsie d two patients with AIDS and disseminated Strongyloides and describe t heir central nervous system findings. The microscopic patterns of brai n infection were dissimilar in the two patients, and reflected histolo gy in systemic viscera. In one patient, a granulomatous response accom panied filariform larvae in all locations, including granulomatous epe ndymitis in brain. Additionally in the brain, larvae without tissue re action were seen. In the second patient, the absence of tissue respons e to larvae was body wide, and isolated parasites were found in centru m semiovale. The occurrence of these patients in a region where Strong yloides is not endemic suggests that this infection may be more preval ent in AIDS than formerly suspected.