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Strongyloidiasis

Anguilluliasis


Presentation

  • 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]
Rigor
  • All patients answered a rigorous questionnaire at each medical appointment during the follow-up, thus guaranteeing the absence of parasite reexposure risk (ie, travel to the endemic area).[doi.org]
  • With so little rigorous data from drug trial treatment of CNS toxocariasis and several cases of spontaneous remission, only tentative conclusions can be drawn from the reported outcomes.[dx.doi.org]
Developmental Disabilities
  • In June 2015, the Pinal County Public Health Services District in Arizona was notified of a suspected strongyloidiasis infection in a resident of a long-term-care facility for developmentally disabled persons.[ncbi.nlm.nih.gov]
Relapsing Polychondritis
  • Google Scholar Schindzielorz A, Edberg SC, Bia FJ: Strongyloides stercoralis hyperinfection and central nervous system involvement in a patient with relapsing polychondritis. Southern Med J. 1991, 84 (8): 1055-1057. 10.1097/00007611-199108000-00030.[doi.org]
Respiratory Insufficiency
  • PubMed Google Scholar Mejia JH, Denis M, Leleu G, Roux P, Mayaud C, Akoun G: [Acute respiratory insufficiency caused by hyperinfestation with strongyloides. BALF diagnosis and favourable outcome]. Rev Pneumol Clin. 1992, 48 (2): 75-78.[doi.org]
Diarrhea
  • However, 5 days later (day 40), the patient developed persistent watery diarrhea and vomiting, leading to dehydration and malnutrition.[ncbi.nlm.nih.gov]
Abdominal Pain
  • General clinical symptoms included abdominal pain (53%), diarrhea (46%), fever (40%), and vomiting (39%).[ncbi.nlm.nih.gov]
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
  • 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]
  • 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]
  • Our patient complained of epigastric pain associated with nausea, vomiting and general weakness.[doi.org]
  • Symptoms of meningitis may include headache, nausea, vomiting, and, in extreme cases, coma.[emedicine.medscape.com]
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).[doi.org]
  • Gastrointestinal manifestations Gastrointestinal symptoms are vague, including epigastric abdominal cramping, indigestion, anorexia, weight loss, nausea, vomiting, chronic diarrhea, constipation, pruritus ani, bloating and, rarely, small bowel obstruction[emedicine.medscape.com]
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]
  • The rash, likely an allergic response to the migrating filariform larvae, often manifests as a pruritic wheal or linear urticaria.[emedicine.medscape.com]
  • 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]
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]
  • 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]
  • 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]
  • CLINICAL PRESENTATION Patients may develop dermatitis when filariform hookworm larvae penetrate the skin.[aafp.org]

Workup

  • 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.[dx.doi.org]
Dirofilaria Immitis
  • Specificity was demonstrated by observing a marked fall in optical density of pooled positive serum after prior incubation with Strongyloides ratti soluble antigen but not after incubation with antigens derived from Ascaris suum or Dirofilaria immitis[ncbi.nlm.nih.gov]
Trypanosoma Cruzi
  • Trypanosoma cruzi epimastigotes were added to each sample before DNA isolation as exogenous amplification control for the extraction and amplification processes [ 11 ].[doi.org]
  • The discovery of Trypanosoma cruzi and of American trypanosomiasis (foot-note to the history of Chagas' disease). Trans. R Soc. Trop. Med. Hyg. 73 : 513 -523. Lewis, T. R. 1872.[cmr.asm.org]
Right Bundle Branch Block
  • His electrocardiogram showed a stable right bundle branch block. The pneumonia resolved, but eight months later (May 2001) he was readmitted unwell, with further left mid-zone pneumonic shadowing on chest X-ray ( Figure 1 ).[doi.org]

Treatment

  • We describe a patient who died of Strongyloides hyperinfection syndrome 2 months after orthotopic heart transplantation and discuss approaches to prevention, diagnosis, and treatment.[ncbi.nlm.nih.gov]

Prognosis

  • 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]

Etiology

  • 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]
  • 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]
  • 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]

Epidemiology

  • Epidemiological "masking" of strongyloidiasis due to overlapping symptoms with other systemic diseases, including allergies, and diagnostic limitations complicate our understanding of the epidemiological extent of this disease, and auto-infection allows[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

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

Prevention

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

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