Clinical features of Strongyloides stercoralis infection in an endemic area of the United States

Severe strongyloidiasis in corticosteroid-treated patients: Case series and literature review

“…141 Even in the Baermann method, the Harada-Mori filter paper and especially the agar-plate culture method are much more sensitive than single stool-smear, 142 they are not standard procedures in most clinical parasitology laboratories and have to be clearly required once the diagnosis suspected. Moreover, the rate of eosinophilia was low in our series (lower than in others which report an hypereosinophilia among more than 50% of patients, 129,131,139 ) may be because of the eosinophil-lowering role of corticosteroids. Taken together, this points out the difficulties in the diagnosis of severe strongyloidiasis and explains why Ss infection was treated before death in only 83% of patients.…”

“…Indeed, in a second study, Sanchez et al 138 described the epidemiology and clinical features of 152 prospectively identified cases of strongyloidiasis (patients receiving or not corticosteroids) and found a male/female ratio of 3/1. A third study 139 reviewing 3271 stool examinations (52 patients infected with Ss), this ratio was 2/1. In another, 131 men had a 3.9 [1.24e11.41] greater risk of having Ss infection than women.…”

Helminths: an unrecognised disease burden prevalent among migrants in the gastroenterology clinic

“…Current protocols for investigation of gastrointestinal symptoms do not incorporate screening for clinically important helminth infections in migrants before referral for more expensive or invasive investigations. While the evidence for a causal role of chronic helminth infection in gastrointestinal symptoms is debated, some studies, and our clinical experience, recognise clear symptom associations with Strongyloides 2 13–17 29. Of note in this small and unblinded study the majority of patients reported an improvement in their symptoms at their follow-up visit.…”

“…This risk can be mitigated by screening and treating patients before immunosuppression. Disseminated infection is rare but diagnosis of chronic infection is warranted, even in immunocompetent hosts because it is associated with a range of non-specific gastrointestinal manifestations 13–17. Prompt diagnosis and treatment may therefore reduce expensive and invasive cycles of unnecessary investigations within outpatient clinics.…”

Severe strongyloidiasis complicated by meningitis and hydrocephalus in an HTLV-1 carrier with increased proviral load

“…Although the mechanism of hypoalbuminemia remains unclear, protein loss from the damaged intestine and/or malabsorption has been suggested. 11 The purulent meningitis was also suspected to have resulted from impaired immunity, which would have allowed the migration of invasive filariform larvae carrying pyogenic organisms from the intestine into the cerebrospinal area. 10,12 Moreover, hydrocephalus with gait disturbance developed after the treatment for severe meningitis in our patient.…”