Presentation
Strongyloidiasis is presently rare in Western Countries, often with delayed diagnosis due to a lack of clinical suspicion, nonspecific presentation, and low parasite intestinal output. [ncbi.nlm.nih.gov]
Entire Body System
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Weight Loss
We report the case of a Gabonese HIV-patient who presented with haemoptysis, weight loss, fulminant diarrhoea and subsequent ileus and elevated CD4 T-cell counts. [ncbi.nlm.nih.gov]
loss, abdominal pain, malabsorption or other symptoms Infection usually occurs in the small intestine but may occur in the stomach, colon or rarely elsewhere Rhabditiform larvae may change into filariform larvae that penetrate the intestinal wall and [pathologyoutlines.com]
Abdominal symptoms may occur after the parasite matures to adults resembling peptic ulcer, weight loss, vomiting and diarrhea. Hives-like rashes may be seen in the area of the buttocks and around the trunk. [outbreaknewstoday.com]
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Gastric Lavage
Further parasitological studies performed after the start of the treatment with ivermectin on fresh fecal samples, gastric lavages and tracheal aspirates showed scanty mobile filariform and rabditoid larvae of the same parasite. [ncbi.nlm.nih.gov]
Respiratoric
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Cough
The patient was successfully treated with vancomycin; although fever and productive cough persisted. Severe gastrointestinal symptoms and pneumonia developed three weeks later. [ncbi.nlm.nih.gov]
This is partially digested blood tinged sputum coughed up, or perhaps swallowed, then coughed up. It has the apperance of wet coffee grounds, hence the description. [thunderhouse4-yuri.blogspot.com]
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Hemoptysis
A 47-year-old man who had lived in Laos and was taking prednisone for dermatomyositis presented with a 4-day history of abdominal pain, fever, melena, and hemoptysis and a 2-week history of rash. [nejm.org]
Hemoptysis increased and mechanical ventilation was started when confusion, hypercapnia, and hypoxemia developed. Six hours later, the patient died. [archbronconeumol.org]
Three days thereafter, he presented with bronchospasm, cough, hemoptysis, and dyspnea. The chest x-ray showed bilateral pulmonary infiltrates suggesting severe infection or pulmonary embolism. [scielo.br]
Gastrointestinal
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Diarrhea
He was initially diagnosed to have diarrhea secondary to norovirus and later with Escherichia coli. He was treated with levofloxacin but the diarrhea persisted. [ncbi.nlm.nih.gov]
Keywords Strongyloides Diagnostic Eosinophilia Diarrhea Tropical medicine Parasitic infection Introduction Case Presentation A 63-year-old-male Vietnam War veteran noted a 6-month history of watery diarrhea. [doi.org]
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Chronic Diarrhea
CONCLUSIONS Our case highlights that S. stercoralis may be an underdiagnosed/under-reported cause of chronic diarrhea among HIV-infected patients. [ncbi.nlm.nih.gov]
"Strongyloidiasis as a Cause of Chronic Diarrhea, Identified Using Next-Generation Strongyloides stercoralis-Specific Immunoassays". Current Tropical Medicine Reports. 1 (3): 145–147. doi : 10.1007/s40475-014-0026-7. [en.wikipedia.org]
Clinicians must consider invasive strongyloidiasis in patients with chronic diarrhea and peripheral eosinophilia, especially in people who have lived in or traveled to endemic areas. [doi.org]
In addition, peripheral eosinophilia, chronic diarrhea, malabsortion syndrome, and chronic anemia are unspecific indications of S. stercoralis infection and should alert clinicians. [archcid.com]
Chronic diarrhea can be a symptom. In severe cases, edema may result in obstruction of the intestinal tract, as well as loss of peristaltic contractions. Strongyloidiasis in immunocompetent individuals is usually an indolent disease. [monsterologist.blogspot.com]
Liver, Gall & Pancreas
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Liver Dysfunction
After 10 weeks, he developed abdominal distension, leucocytosis, thrombocytopenia, liver dysfunction, coagulopathy, and respiratory failure. Stool examination showed larvae of Strongyloides stercoralis. [ncbi.nlm.nih.gov]
Musculoskeletal
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Back Pain
He had a medical history including aortic valve replacement, diabetes mellitus, spinal stenosis, and low back pain treated with repeated local steroid injections. [ncbi.nlm.nih.gov]
Skin
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Pruritus
[…] infection occurs in immunocompetent individuals, the infection is usually asymptomatic, as occurs with clinical manifestations, they usually include general symptoms unspecific (fever, malaise, chronic wasting), dermatologic (generalized urticaria, pruritus [ivami.com]
Although symptoms can include pruritus, cough, dyspnea, diarrhea, and abdominal pain [ 2 ], patients can also remain asymptomatic. [doi.org]
When evaluating candidates for receiving a kidney transplant, special attention must be paid to the presence of unexplained eosinophilia and a history of corticoidresistant pruritus or asthma in order to diagnose a possible parasitic infection and eradicate [revistanefrologia.com]
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Cutaneous Larva Migrans
Larva currens (creeping infection) is a form of cutaneous larva migrans specific to Strongyloides infection; it results from autoinfection. The eruption usually begins in the perianal region and is accompanied by intense pruritus. [merckmanuals.com]
Face, Head & Neck
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Neck Mass
CASE REPORT: This is a case of angioimmunoblastic T-cell lymphoma (AITL) in a patient with lymphadenopathy and bulky neck mass. [ncbi.nlm.nih.gov]
Neurologic
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Polyradiculoneuropathy
Abstract A 50-year-old villager with chronic inflammatory demyelinating polyradiculoneuropathy developed pain abdomen, diarrhea, and vomiting after 8 weeks of prednisolone (40 mg/day) therapy. [ncbi.nlm.nih.gov]
Workup
The finding of S. stercoralis eggs should be considered in the diagnostic workup of persisting hematuria that occurs after stem cell transplantation. [academic.oup.com]
Serum
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Microcytic Anemia
A complete blood count with differential revealed microcytic anemia with hemoglobin 3.1 g/dL and eosinophilia 26.4%. [acgcasereports.gi.org]
Microbiology
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Paracoccidioides Brasiliensis
Examination of a smear prepared from aspirated tracheobronchial secretion and stained by Grocott-methenamine-silver revealed structures consistent with Paracoccidioides brasiliensis and Strongyloides stercoralis. [ncbi.nlm.nih.gov]
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Human Papillomavirus
The anal-rectal cytology is introduced recently to evaluate human-papillomavirus related cellular changes in the cells of anal canal. It is especially useful in high risk patients such as HIV patients. [ncbi.nlm.nih.gov]
Treatment
Treatment options include ivermectin, thiabendazole, or albendazole. Information on the best treatment for disseminated disease and hyperinfection is limited. [ncbi.nlm.nih.gov]
Prognosis
Aneosinophilia is frequent and is associated with a poor prognosis and elevated mortality rate. [archcid.com]
Absence of eosinophilia indicates poor prognosis. 2 Although thiabendazole was the treatment of choice for strongyloidosis and still a first choice of drug, it has now been replaced by ivermectin. 8 It is fairly well tolerated and has a higher cure rate [omjournal.org]
However, eosinophilia is absent in disseminated disease, indicating a poor prognosis [ 9 ]. Our patient had an initial eosinophilia, which became normal after treatment. [acmicrob.com]
[…] count, the worse the prognosis. [infectiousdiseaseadvisor.com]
Eosinopenia and increased IgE levels have been associated with poor prognosis [ 14, 24 ]. A high index of suspicion is essential for correct diagnosis of S. Stercoralis related duodenal obstruction. Travel history plays an important role. [omicsgroup.org]
Etiology
Stercoralis is an uncommon etiology for proximal bowel obstruction, high index of suspicion should be exercised in patients presenting as above and recent travel to areas endemic for S. Stercoralis. [omicsgroup.org]
Laboratory investigations revealed eosinophil count of 10% at the time of admission with total count of 18,000 (Table 1) .Ultra sonogram of abdomen showed calcified granuloma in spleen, suggestive of post infectious etiology. [acmicrob.com]
Manifestations of infection can range from asymptomatic eosinophilia to severe, life-threatening disease in immunocompromised patients. [2] Etiology Strongyloides stercoralis is a soil-transmitted helminth. [ncbi.nlm.nih.gov]
Case 3 A 38-year-old Saudi male was diagnosed with ESRD of unknown etiology and was started on hemodialysis. His past medical and travel history as well as pre-transplant work up were not significant. [sjkdt.org]
Epidemiology
Box, CH-4002 Basel, Switzerland; Epidemiology, Biostatistics and Prevention Institute, University of Zurich, P.O. Box, CH-8001 Zurich, Switzerland. 8 Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. [ncbi.nlm.nih.gov]
Pathophysiology
[…] who have sex with men Sites Infection usually occurs in the lung and small intestine The stomach, colon, appendix and liver may also be affected Involvement of the central nervous system may occur with disseminated disease Esophageal disease is rare Pathophysiology [pathologyoutlines.com]
Pathophysiology Infection occurs through skin contact with soil that contains the filariform (infective) larvae. After penetrating the skin, larvae travel to the lungs where it matures. It then travels up the trachea. [ncbi.nlm.nih.gov]
While the pathophysiology of this process is unknown, some experts have postulated that reconstitution of the Th-1 immune response may promote development of invasive filariform larvae capable of autoinfection and migration [ 6, 9 ]. [link.springer.com]
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]
Prevention
This study aimed to evaluate the impact of the Health Education and Preventive Equipment Package (HEPEP), a package we developed to improve awareness and aid in the prevention of Strongyloides stercoralis infection among rural communities in northeast [ncbi.nlm.nih.gov]
From the Department of Preventive Medicine and Community Health and the Department of Pathology, New Jersey Medical School Newark, New Jersey Search for other works by this author on: Purnendu Sen From the Department of Preventive Medicine and Community [doi.org]