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Strongyloides hyperinfection risk — RCPSC IM MCQ

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HardInfectious DiseasesStrongyloides hyperinfection riskRCPSC IM

A 62-year-old man from Cambodia is admitted with severe COPD exacerbation requiring high-dose corticosteroids. He has chronic intermittent diarrhea and eosinophils are 1.4 x 10^9/L. Chest radiograph shows hyperinflation without pneumonia. He has not previously been screened for parasites. What is the most appropriate investigation?

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Correct answer: D — Strongyloides serology with empiric ivermectin if immunosuppression cannot wait

Patients from endemic areas with eosinophilia who need corticosteroids should be assessed for Strongyloides; empiric ivermectin is reasonable if urgent immunosuppression is needed because hyperinfection can be fatal.

Reference: Canadian immigrant and refugee health infectious disease guidance