We present a case of strongyloidiasis presenting as larva currens 38 years after potential exposure in a country with what is typically thought of as low epidemiologic risk. [ncbi.nlm.nih.gov]

We present a case where this infection was successfully treated and review the available literature. Cases may present many years after they have left an area endemic for Strongyloides infection, emphasizing the need for a full travel history. [doi.org]

• Weakness

  Our patient complained of epigastric pain associated with nausea, vomiting and general weakness. [doi.org]

  Some people may experience, nausea, vomiting, weight loss, weakness or constipation. In chronic infections skin and chest symptoms can persist. The time from infection until a person might develop symptoms is variable. [nt.gov.au]

  A 66-year-old postrenal transplant male presented with dry cough, dysphagia, and epigastric pain for 1 week and altered sensorium and generalized weakness since the last 1 day. [lungindia.com]

  Cysticercosis ILLUSTRATIVE CASE A 57-year-old Cambodian woman with a seven- to eight-year history of headaches was admitted because of worsening headaches, right-sided weakness and the vomiting of clear fluid. [aafp.org]

  At the onset of the clinical course, weak humoral reactivity may lead to false-negative results in immunological tests ( 199 ). [cmr.asm.org]

• Camping

  […] home" for travellers and returned servicemen, data collected from rural and remote Indigenous communities in Western Australia, Northern Territory, Queensland and New South Wales document hyperendemic prevalence rates greater than those from refugee camps [tropicalhealthsolutions.com]

  Tropical Pancreatitis ILLUSTRATIVE CASE A 31-year-old southern Sudanese man came to the United States after living in a refugee camp where food was scarce. [aafp.org]

  Symptomatic infections in World War II veterans have been described more than 50 years after the subjects had been released from prisoner-of-war (POW) camps in Southeast Asia.[ 2 ] The risk factors for infection are low socio-economic status, alcoholism [tropicalgastro.com]

  East Africa Group A, C, B * Immigrants (≥16) lived in the refugee camps, Melbourne community health center and clinic patients Developing economy 1 ** 11% (14/124) Serology Fever (34%), Stomach pain (30%), weight loss (25%), and diarrhea (13%) Arrived [mdpi.com]

• Diarrhea

  However, 5 days later (day 40), the patient developed persistent watery diarrhea and vomiting, leading to dehydration and malnutrition. [ncbi.nlm.nih.gov]

  The worms usually inhabit the small intestines, causing intestinal strongyloidiasis with diarrhea and ulceration of the mucosa. [medical-dictionary.thefreedictionary.com]

• Abdominal Pain

  Complicated strongyloidiasis should be suspected in immunocompromised hosts who present with abdominal pain, vomiting and diarrhoea, particularly in endemic areas. [ncbi.nlm.nih.gov]

  The patient's abdominal pain decreased after he began taking pancreatic enzyme supplements orally with low-fat meals. [aafp.org]

• Constipation

  All patients presented with gastrointestinal symptoms (abdominal pain, vomiting, diarrhea, constipation and paralytic ileus), as well as pulmonary symptoms (cough, dyspnea and blood-stained sputum). Albendazole 800 mg twice daily orally was started. [ncbi.nlm.nih.gov]

  Severe infection of the intestine is debilitating and causes vomiting, diarrhea, and constipation. This is often associated with the autoinfective cycle. [histopathology-india.net]

  Some people develop abdominal pain, bloating, heartburn, intermittent episodes of diarrhea and constipation, a dry cough, and skin rashes. Rarely people will develop arthritis, kidney problems, and heart conditions. [cdc.gov]

  Some people may experience, nausea, vomiting, weight loss, weakness or constipation. In chronic infections skin and chest symptoms can persist. The time from infection until a person might develop symptoms is variable. [nt.gov.au]

  Profuse watery diarrhoea, sometimes alternating with constipation. Malabsorption. Weight loss. Pulmonary involvement (including Löffler's disease) can occur during pulmonary migration of the filariform larvae: Cough. Bronchospasm. Haemoptysis. [patient.info]

• Nausea

  Our patient complained of epigastric pain associated with nausea, vomiting and general weakness. [doi.org]

  The hyponatremia gradually improved initially, but the appetite loss, nausea, and hyponatremia continued. [ncbi.nlm.nih.gov]

  Gastrointestinal symptoms may include diarrhoea, abdominal pain and occasionally nausea and vomiting. Patients may also have a low-grade fever, coughing and wheezing, due to the migration of larvae through the lungs. [dermnetnz.org]

  The most common manifestations of infection are mild and may include epigastric pain, mild diarrhea, nausea, and vomiting. At the site of filariform penetration, skin may be inflamed and itchy-this is referred to as "ground itch." [mayomedicallaboratories.com]

  Some people may experience, nausea, vomiting, weight loss, weakness or constipation. In chronic infections skin and chest symptoms can persist. The time from infection until a person might develop symptoms is variable. [nt.gov.au]

• Chronic Diarrhea

  Uday C Ghoshal, Amit Goel, Ujjala Ghoshal, Manoj Jain, Asha Misra and Gourdas Choudhuri, Chronic diarrhea and malabsorption due to hypogammaglobulinemia: a report on twelve patients, Indian Journal of Gastroenterology, 30, 4, (170), (2011). [dx.doi.org]

  In classic cases, diarrhea is profuse, watery, and mucoid. Periods of alternation between diarrhea and constipation may occur. [emedicine.medscape.com]

  Among AIDS patients, strongyloidiasis is more commonly associated with chronic diarrhea ( 4, 7, 8 ). [ncbi.nlm.nih.gov]

• Myalgia

  An important symptom cluster for diagnosis is the combination of swelling facial lesions on the lids or the lips, an acute fever, and myalgias. [cmr.asm.org]

• Dermatitis

  Strongyloidiasis, a gastrointestinal infection by the helminth Strongyloides stercoralis, and Infective Dermatitis associated with HTLV-1 (IDH), appear to be risk factors for the development of HTLV-1 related diseases. [ncbi.nlm.nih.gov]

  Delusional parasitosis is sometimes difficult for doctors to diagnose because many actual skin disorders, such as allergies, dermatitis, or real parasites, also cause the itching sensations. [merckmanuals.com]

  Invading larvae cause transient dermatitis. Larvae migrating through the lungs may provoke cough, hemoptysis, and dyspnea, but most infections do not lead to pulmonary symptoms. [histopathology-india.net]

  Can cause dermatitis and balanoposthitis due to percutaneous entry, or diarrhea when the intestinal infection is very heavy. In kangaroos it is a stomach parasite causing gastritis. [medical-dictionary.thefreedictionary.com]

  CLINICAL PRESENTATION Patients may develop dermatitis when filariform hookworm larvae penetrate the skin. [aafp.org]

• Urticaria

  Among these, 52 patients (61.9%) reported skin-related problems (pruritus, urticaria, angioedema, and/or rash). Forty-nine patients (58.3%) had asthma, and 73.8% had allergic rhinoconjunctivitis. [ncbi.nlm.nih.gov]

  Symptoms Strongyloidiasis may cause intermittent symptoms that mostly affect the intestine (abdominal pain and intermittent or persistent diarrhoea), the lungs (cough, wheezing, chronic bronchitis) or skin (pruritus, urticaria). [who.int]

  The symptoms can include diarrhea, enteropathy with malabsorption, skin rashes, such as larva currens, or urticaria. In the context of pulmonary disease, hypereosinophilia is common. Finally there can be massive strongyloidiasis with dissemination. [coursera.org]

  CLINICAL PRESENTATION The classically recognized triad of symptoms in chronic strongyloidiasis are urticaria (episodic, rapidly moving urticarial skin eruptions, most often on the buttocks and perianal area), abdominal pain and diarrhea. [aafp.org]

  The rash, likely an allergic response to the migrating filariform larvae, often manifests as a pruritic wheal or linear urticaria. [emedicine.medscape.com]

• Sweating

  Renoult, who writes that “A most stubborn haematuria manifested itself amongst the soldiers of the French army… continual and very abundant sweats diminished quantity of urine…becoming thick and bloody” ( 225 ). [cmr.asm.org]

• Blister

  Pressure sores and friction blisters developed on the buttock and inguinal area. She complained of progressive cough, sputum and shortness of breath. There were rales on both lower lung fields and diminished breath sound at the base of the Rt. lung. [doi.org]

• Confusion

  His headaches returned and he became confused. He was admitted to hospital in septic shock with nuchal rigidity. His blood cultures and CSF culture grew E coli. A strongyloides organism was seen in his CSF sample. [coursera.org]

  Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances False-positive results may occur with other helminth infections, including [mayomedicallaboratories.com]

  Clinical signs and symptoms of severe strongyloidiasis can occur suddenly and involves severe abdominal pain, nausea and vomiting, bloody diarrhoea, coughing up blood, shortness of breath, stiff neck, headache, confusion, fever, chills and skin rash. [dermnetnz.org]

  […] course of thiabendazole for strongyloidiasis [bilirubin 30.6 rising to 40.5 mg/dL, AST 562 U/L, Alk P 820 U/L], and dry eyes, but normal salivary gland biopsy, liver biopsy showing intrahepatic cholestasis without duct loss, prolonged, severe course [confusion [livertox.nih.gov]

  Early descriptions of the worm tend to be unreliable because, as has already been mentioned, there was considerable confusion with the two common species of Taenia. [cmr.asm.org]

Seroconversion is likely valuable for the diagnostic workup ( 247 ). The use of purified antigens, the study of class or isotype response, and extensive standardization studies are necessary to improve molecular diagnosis in NSM. [cmr.asm.org]

Awareness of the interaction between HTLV-I and strongyloidiasis has important implications in terms of prognosis and treatment. [ncbi.nlm.nih.gov]

Awareness of the interaction between HTLV-I and strongyloidiasis has important implications in terms of prognosis and treatment. [ncbi.nlm.nih.gov]

Outlook (Prognosis) With proper treatment, the worms can be killed and full recovery is expected. Sometimes, treatment needs to be repeated. [ufhealth.org]

Prognosis Appropriate antihelminthic treatment results in a cure for the majority of patients, although re-infection is common in endemic areas. [patient.info]

He was admitted with signs and symptoms of acute bacterial meningitis, reporting four other meningitis episodes in the past 6 years, with an etiological diagnosis of Escherichia coli and Enterococcus faecium in two cases. [ncbi.nlm.nih.gov]

Etiology The female nematodes, which measure 2.5 mm in length, live in the small intestine of humans. Eggs laid in the small intestine hatch to release larvae that are normally excreted in the faeces. [orpha.net]

A new insight of etiology? Med Hypothesis 2007;68:1351-8. 2. Rapini RP, Bolognia JL, Jorizzo JL. Dermatology. St Louis: Mosby; 2007. 3. Freedberg IM, Fitzpatrick TB. Fitzpatricks dermatology in general medicine. 6 th ed. [doi.org]

Anthelmintic Therapy Strongyloides infection should be suspected in a patient with nonspecific gastrointestinal, respiratory, or recurrent dermatologic symptoms of unclear etiology with risk factors for Strongyloides infection. [emedicine.medscape.com]

Thus, serology is the strongest source of information for strengthening the etiological hypothesis. [cmr.asm.org]

This case highlights several important features of strongyloidiasis, including its varied epidemiology, long incubation period, and cutaneous manifestations. [ncbi.nlm.nih.gov]

Now let’s discuss strongyloidiasis, pathophysiology, clinical manifestations and treatment. Strongyloidiasis transmission occurs by exposure to larvae in soil. The larvae penetrate the skin, enter the venous circulation, and migrate to the lungs. [coursera.org]

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Strongyloidiasis is caused by Strongyloides stercoralis, a nematode endemic to tropical and subtropical regions worldwide. [mayomedicallaboratories.com]

Pathophysiology The life cycle of Strongyloides stercoralis is complex and unique among the intestinal nematodes. [emedicine.medscape.com]

In: Harawi SJ, O'Hara CJ (eds) Pathology and pathophysiology of AIDS and HIV-related diseases. London: Chapman & Hall Medical, 1989:327. Google Scholar 3. Shikiya K, Saito A. Strongyloidiasis. Clin Microbiol 1993;6:1011–1015 (in Japanese). [link.springer.com]

Clinical Manifestations and Pathophysiology Transplant recipients are at risk for developing Strongyloides hyperinfection syndrome, from chronic intestinal Strongyloides infection, acquisition of primary Strongyloides infection in areas of endemicity, [academic.oup.com]

Waterborne, and Environmental Diseases, Centers for Disease Controls and Prevention, Atlanta, Georgia, United States of America. [ncbi.nlm.nih.gov]