The NOW S. pneumoniae urinary antigen test positivity rate 6 weeks after pneumonia onset and among patients with COPD.

kilogram of body weight was given. A series of examinations of stool and sputum samples conducted over a 10-month period revealed no recurrence, and this was confirmed by the negative results of 2 stool cultures. The patient died in September 1998 of progressive HIV disease. This is the first report from Uganda of Strongyloides hyperinfection syndrome complicating AIDS. This is surprising, given the large rural population with AIDS who would be susceptible to Strongyloides hyperinfection syndrome. Though this could be in keeping with the reported lack of association between AIDS and Strongyloides infection [3], poor investigative facilities and lack of awareness are other factors that might explain this fact. Treatment of Strongyloides hyperinfection is difficult, especially in a rural setting, where the choice of drugs is severely limited, as was well-illustrated by this case. Treatment with the most common antihelminthic agent available in rural Uganda, mebendazole, was clearly ineffective. Albendazole and single-dose ivermectin therapy were both temporarily effective in clearing intestinal larvae. A higher dosage of albendazole was no better than a standard dosage in treatment of disseminated disease. A 3-day course of therapy with ivermectin, on the other hand, resulted in an apparent clearance of larvae from all body sites, resulting in a sustained larvafree period until the death of the patient due to underlying immunosuppression. This report shows that Strongyloides hyperinfection syndrome does occur in association with AIDS in Uganda. It also suggests that albendazole and single-dose ivermectin may be useful in treatment of uncomplicated AIDS-associated Strongyloides infection. However, in the presence of dissemination, a longer course of ivermectin appears superior. The presence of Strongyloides in a patient’s stool and the concurrent presence of chest symptoms should prompt clinicians to examine sputum samples for larvae. Acknowledgments