Chronic Strongyloidiasis in World War II Far East Ex-Prisoners of War *

Abstract

Fifty-two of 142 (37%) American ex-prisoners of war that worked on the Burma-Thailand Railroad during World War II were found to have previously unrecognized symptomatic Strongyloides stercoralis infections. A characteristic urticarial creeping skin eruption on the abdomen, buttocks and thighs occurred in 92%. Infection was also associated with pruritus ani, abdominal pain, indigestion, heartburn, and diarrhea. Demonstration of larvae in ether-formalin stool concentrates in these chronic low density infections required 5 hours of microscopy per case to detect 90% of positive cases. Therapy with thiabendazole resulted in a clinical cure in 93% and a microscopic cure in 100%; but was associated with frequent side effects. Chronic strongyloidiasis should be considered in veterans of Far East conflicts and in others with intimate soil contact in rural Strongyloides stercoralis-endemic areas who present with recurrent creeping skin eruption, abdominal pain, and eosinophilia.

Maltreatment of Strongyloides Infection: Case Series and Worldwide Physicians-in-Training Survey

“…The reported sensitivity of three routine stool specimens by direct examination is reported as 50%. 1,19,26,27 In this study, three stool ova and parasite examinsations detected 83% of strongyloidiasis cases; however, 17% had ≥3 prior false * In the case of surveys in Brazil and Thailand, the individual was reported to be from a "rural area." negative specimens.…”

Strongyloidiasis: A case with acute pancreatitis and a literature review

“…Due to improvement in sanitary conditions and hygienic practices, these prior studies had shown marginal decline in prevalence from 3.8% to 3% [7] . In studies among veterans returning from endemic regions and immigrants, respective prevalence as high as 37% [8] and 40% [5] has been recorded. Since…”

Serology and eosinophil count in the diagnosis and management of strongyloidiasis in a non-endemic area.

“…Since only small numbers of Strongyloides larvae are shed in the feces, conventional parasitologic methods (direct fecal smear and formalinether concentration) have low diagnostic sensitivity, even with repeated examinations. [6][7][8][9][10] Although the Baermann technique and fecal culture are more sensitive, they are timeconsuming and must be performed on fresh stool samples. [11][12][13] Other techniques, such as duodenal intubation with biopsy and the Enterotest™ (Hedeco Co., Palo Alto, CA) are reported to have higher sensitivity, but are cumbersome and not routinely used.…”