Presentation
One month before presentation, he had been hospitalized and treated with high-dose glucocorticoids for diffuse alveolar hemorrhage. [nejm.org]
The presentation and evolution of this infection are determined by the interaction between the host and the parasite. [scielo.org.co]
Case Presentation A 45 year old African man who emigrated from Ghana a few years ago presented to our Emergency Department (ER) with complaints of progressively worsening nausea and vomiting after meals for over one year. [omicsonline.org]
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
- 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]
- Anemia
PRINCIPAL FINDINGS: STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). [ncbi.nlm.nih.gov]
The patient presented with abdominal pain and chronic anemia for 1 year, with negative laboratory tests for parasites and normal acute phase reactants. [scielo.org.co]
- Inflammation
This is usually associated with extensive inflammation and immune activation. [ncbi.nlm.nih.gov]
[…] diarrhea, malabsorption Severe / fatal infections in immunocompromised, due to worms moving from GI tract into other organs ( WormBook 2007:1 ) Diagnosis Larvae in stool Adult female or eggs in small bowel mucosa, often with eosinophilic or granulomatous inflammation [pathologyoutlines.com]
It contains fragments of colonic mucosa that have inflammation and sheets of eosinophils. [doi.org]
- Swelling
A 58-year-old male diabetic who was operated for carcinoma larynx 4 years back was admitted with exertional dyspnoea and bilateral leg swelling for the past 2 years. Over the last 2 months, there was a progressive worsening of symptoms. [ncbi.nlm.nih.gov]
Clinical Manifestations Dermatitis, swelling, itching, larva currens and mild hemorrhage at the site where the skin has been penetrated Pnuemonia-like symptoms Lofflers syndrome Tissue damage, sempsis and ulcers Hyperinfection syndrome has a mortality [slideshare.net]
An S. stercoralis infection can cause the following complications: Eosinophilic pneumonia Eosinophilic pneumonia occurs when your lungs swell due to an increase in eosinophils. [healthline.com]
Respiratoric
- Cough
Symptoms include rash, pulmonary symptoms (including cough and wheezing), and abdominal pain with diarrhea. [merckmanuals.com]
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]
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]
- Hemoptysis
After 8 weeks of albendazole and voriconazole treatment, his symptoms were relieved, and his hemoptysis disappeared. [jtd.amegroups.com]
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]
Gastrointestinal
- 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]
Symptoms include rash, pulmonary symptoms (including cough and wheezing), and abdominal pain with diarrhea. [merckmanuals.com]
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]
- 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]
In addition, peripheral eosinophilia, chronic diarrhea, malabsortion syndrome, and chronic anemia are unspecific indications of S. stercoralis infection and should alert clinicians. [archcid.com]
"Strongyloidiasis as a Cause of Chronic Diarrhea, Identified Using Next-Generation Strongyloides stercoralis-Specific Immunoassays". [en.wikipedia.org]
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]
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]
- Loss of Appetite
appetite and loss of weight for past one month with fever off and on. [ncbi.nlm.nih.gov]
Strongyloidiasis can be clinically inapparent or manifests as cutaneous symptoms (serpiginous rash termed larva currens), or mild gastrointestinal symptoms (abdominal discomfort, diarrhea, nausea, loss of appetite) or pulmonary symptoms (cough and breathlessness [acmicrob.com]
People with symptoms show digestive tract-related issues that include the following: Loss of appetite Diarrhea Abdominal pain Gas Constipation Rash People with advanced cases may have more severe symptoms, including the following: Wheezing Cough Hoarseness [webmd.com]
Case Presentation A 56-year-old Caucasian male, chronic smoker (63 pack-years), with a previously unremarkable medical history, complained of loss of appetite, postprandial fullness, epigastric discomfort, and a significant weight loss of 10 kg in the [karger.com]
- Dyspepsia
He had complaints of dyspepsia since 2000 and was receiving intermittent treatment with H-2 blockers (ranitidine) and occasionally by proton pump inhibitor, (omiprazole). [omjournal.org]
Hyperinfection syndrome is characterized by a spectrum of gastrointestinal complaints including abdominal pain, dyspepsia, diarrhea, constipation, ileus, obstruction, enteritis, and/or gastrointestinal bleeding. [ncbi.nlm.nih.gov]
- Gagging
Amplification of the variable V3–V4 regions from the 16S rRNA bacterial gene (∼460 bp) was carried out using the primer pairs 16S_F 5′-(TCG TCG GCA GCG TCA GAT GTG TAT AAG AGA CAG CCT ACG GGN GGC WGC AG)-3′ and 16S_R 5′-(GTC TCG TGG GCT CGG AGA TGT GTA TAA GAG [mdpi.com]
Musculoskeletal
- 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
- Pruritus
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 eruption usually begins in the perianal region and is accompanied by intense pruritus. Typically, larva currens is a linear or serpiginous, rapidly migrating, erythematous, urticarial skin lesion. [merckmanuals.com]
[…] 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]
- 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]
Psychiatrical
- Suggestibility
The attractant activity of urocanic acid is suppressed by divalent metal ions, suggesting a possible strategy for preventing infection. [ncbi.nlm.nih.gov]
Biopsy taken from D2 and esophagus was suggestive of Strongyloidiasis. Wet film of stool showed larva of S. stercoralis. [acmicrob.com]
Sampling of the proximal small bowel by aspiration may be positive in low-level infections and should be done endoscopically to permit biopsy of suspicious duodenal and jejunal lesions in patients with findings that suggest strongyloidiasis (eg, eosinophilia [merckmanuals.com]
- Visual Hallucination
Her medical history included febrile episode, visual hallucinations, abdominal pain, respiratory stress, and widespread skin rash. [mdpi.com]
Neurologic
- Neglect
The soil-transmitted threadworm, Strongyloides stercoralis, is one of the most neglected among the so-called neglected tropical diseases (NTDs). [ncbi.nlm.nih.gov]
Hotez, One World Health: Neglected Tropical Diseases in a Flat World, PLoS Neglected Tropical Diseases, 3, 4, (e405), (2009). Yupin Suputtamongkol, Nuntakorn Kungpanichkul, Saowaluk Silpasakorn and Nicholas J. [doi.org]
Related links WHO fact sheet on soil-transmitted helminth infections Soil-transmitted helminth infections Neglected tropical diseases [who.int]
PLoS Neglected Tropical Diseases 2014 ; 8 : e2640. [cambridge.org]
- Agitation
These larvae have a tripartite pointed tail which, when viewed with a dissecting microscope, appears like a simple fork ( Figure 5 ); these larvae are highly active in liquid following gentle agitation. Figure 3 A parasitic female of S. ratti. [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. [doi.org]
Serum
- Microcytic Anemia
anemia (J Clin Gastroenterol 1999;28:77) 68 year old woman with coexisting rheumatoid arthritis (Ann Clin Microbiol 2010;9:27) Treatment Infection should always be treated Ivermectin is the first line treatment in most cases Albendazole or thiabendazole [pathologyoutlines.com]
A complete blood count with differential revealed microcytic anemia with hemoglobin 3.1 g/dL and eosinophilia 26.4%. [acgcasereports.gi.org]
Microbiology
- Necator Americanus
americanus Onchocerca volvulus Strongyloides stercoralis Trichinella spiralis Trichuris trichiura Wuchereria bancrofti Animal Parasitic Nematodes Ancylostoma caninum Ascaris suum Cooperia oncophora Dictyocaulus viviparus Dirofilaria immitis Haemonchus [nematode.net]
Ciclos evolutivos de Strongyloides stercoralis, Ancylostoma duodenale y Necator americanus Alfonso Bonilla Naar Resumen (es_ES) Se muestra gráficamente cómo se desarrollan éstos parásitos desde la fase de desarrollo hasta el contacto con el ser humano [revistas.unal.edu.co]
americanus), Trichuris trichiura, and Strongyloides stercoralis. [thelancet.com]
- Trichinella Spiralis
spiralis Trichuris trichiura Wuchereria bancrofti Animal Parasitic Nematodes Ancylostoma caninum Ascaris suum Cooperia oncophora Dictyocaulus viviparus Dirofilaria immitis Haemonchus contortus Litomosoides sigmodontis Nematodirus battus Nippostrongylus [nematode.net]
However, a recent study on the intestinal nematode Trichinella spiralis showed that Bacteroides genus displayed increased abundances in the T. spiralis positive stool samples when compared with the negative samples [17]. [mdpi.com]
Trichinella and Trichinosis Trichinosis, also known as trichinellosis and trichina infection, is caused by the intestinal nematode worm Trichinella spiralis, which requires two hosts in its life cycle. [dx.doi.org]
Treatment
Infection may be fatal in immunocompromised patients, even with treatment. [merckmanuals.com]
Hyperinfection risk factors are age, underlying chronic obstructive pulmonary disease, cortico steroid treatment and antacid or cimetidine treatment 3, 4 ). [kjim.org]
Strongyloides-specific IgG serology decreases with effective treatment and is useful in monitoring eradication.29–32 Treatment The goal of therapy is eradication of all S. stercoralis parasites. [racgp.org.au]
At that time, the cause of the hemorrhage was not identified, but the patient’s condition improved with glucocorticoid treatment. [nejm.org]
There is a paucity of randomised controlled trails investigating the treatment of strongyloides infection, and no Cochrane reviews have been published. [bmj.com]
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]
Prognosis Appropriate antihelminthic treatment results in a cure for the majority of patients, although re-infection is common in endemic areas. [patient.info]
Etiology
In this case report, the authors present a case of upper gastrointestinal bleeding caused by a gastric ulcer with a challenging etiological diagnosis. [karger.com]
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. [omicsonline.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]
Epidemiology
EPIDEMIOLOGY Strongyloidiasis is endemic in rural areas of tropical and subtropical regions and occurs sporadically in temperate areas (Appalachia and southern Europe) [ 1 ]. [uptodate.com]
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]
In this article we review the epidemiology and common symptoms of strongyloidiasis and strongyloides hyperinfection syndrome, discuss the appropriate investigations, and summarise the evidence on treatment. [bmj.com]
Pathophysiology
Pathophysiology Strongyloides adult worms live in the mucosa and submucosa of the duodenum and jejunum. Released eggs hatch in the bowel lumen, liberating rhabditiform larvae. Most of the larvae are excreted in the stool. [merckmanuals.com]
[…] 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]
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 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]
Prevention
Treatment reference Prevention Prevention of primary Strongyloides infections is the same as for hookworms. [merckmanuals.com]
Personal hygienic measures like proper hand hygiene, prevention of contact with infected soil, proper disposal of sewage and health education will help to prevent infection with Strongyloides [ 3 ]. [acmicrob.com]
It is a condition that is preventable and treatable if diagnosed early. GPs must be vigilant to ensure that cases are detected and the risks of fatal, disseminated disease reduced. [racgp.org.au]
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]