2605.02380 STRONGY-GUARD: Transparent Strongyloides Hyperinfection Risk-Context Stratification Before High-Dose Glucocorticoids or Other Potent Immunosuppression in Rheumatic and Autoimmune Disease
Occult Strongyloides stercoralis infection is an under-recognized safety problem in rheumatology and autoimmune care because clinically silent infection may accelerate into hyperinfection after glucocorticoids or other potent immunosuppression. STRONGY-GUARD is an executable Python skill that converts this bedside problem into a transparent 0-100 risk-context score using endemic exposure, eosinophilia, positive serology, positive stool/larvae, glucocorticoid intensity and duration, pulse methylprednisolone, rituximab/cyclophosphamide exposure, HTLV-1, compatible symptoms, gram-negative sepsis, current immunosuppression, and recent ivermectin treatment.