Colonoscopic Findings and Pathologic Characteristics of Strongyloides Colitis: A Case Series

Matsui, Hideki; Hokama, Akira; Makishi, Tomoko; Arakaki, Katsuo; Kinjo, Fukunori; Fujita, Jiro

doi:10.1159/000321812

Cited by 25 publications

(23 citation statements)

References 34 publications

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“…Choudry et al, described pustule-like lesions in the colon which may represent the process of larvae burying themselves in the colonic mucosa [62]. Other findings in the colonic mucosa include loss of haustra and narrowing aphtoid ulceration, yellowish-white nodules, erythema or serpiginous ulcerations [69], [71].…”

Section: Resultsmentioning

confidence: 99%

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The Laboratory Diagnosis and Follow Up of Strongyloidiasis: A Systematic Review

et al. 2013

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BackgroundStrongyloidiasis is frequently under diagnosed since many infections remain asymptomatic and conventional diagnostic tests based on parasitological examination are not sufficiently sensitive. Serology is useful but is still only available in reference laboratories. The need for improved diagnostic tests in terms of sensitivity and specificity is clear, particularly in immunocompromised patients or candidates to immunosuppressive treatments. This review aims to evaluate both conventional and novel techniques for the diagnosis of strongyloidiasis as well as available cure markers for this parasitic infection.Methodology/Principal FindingsThe search strategy was based on the data-base sources MEDLINE, Cochrane Library Register for systematic review, EmBase, Global Health and LILACS and was limited in the search string to articles published from 1960 to August 2012 and to English, Spanish, French, Portuguese and German languages. Case reports, case series and animal studies were excluded. 2003 potentially relevant citations were selected for retrieval, of which 1649 were selected for review of the abstract. 143 were eligible for final inclusion.ConclusionsSensitivity of microscopic-based techniques is not good enough, particularly in chronic infections. Furthermore, techniques such as Baermann or agar plate culture are cumbersome and time-consuming and several specimens should be collected on different days to improve the detection rate. Serology is a useful tool but it might overestimate the prevalence of disease due to cross-reactivity with other nematode infections and its difficulty distinguishing recent from past (and cured) infections. To evaluate treatment efficacy is still a major concern because direct parasitological methods might overestimate it and the serology has not yet been well evaluated; even if there is a decline in antibody titres after treatment, it is slow and it needs to be done at 6 to 12 months after treatment which can cause a substantial loss to follow-up in a clinical trial.

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Section: Resultsmentioning

confidence: 99%

“…Histological examinations can confirm the diagnosis showing sections of larvae, eggs and some adult forms, predominantly in the gastric or duodenal crypts with eosinophilic infiltration in the lamina propia, directly correlated with the intensity of infection [71], [72], [73], [74], [75], [76].…”

Section: Resultsmentioning

confidence: 99%

The Laboratory Diagnosis and Follow Up of Strongyloidiasis: A Systematic Review

et al. 2013

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“…Similarly the colon, particularly rightsided colon, may get involved in the presence of overwhelming parasite burden. Colonoscopy may show colonic mucosa inflammation or nodular mucosa with pathological examination revealing larvae, eosinophilic infiltration or granulomas [38] .…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Strongyloidiasis: A case with acute pancreatitis and a literature review

Makker¹,

Balar²,

Niazi³

et al. 2015

WJG

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Strongyloides stercoralis, a soil transmitted helminth infection, affects millions with varying prevalence worldwide. A large number of affected hosts are asymptomatic. Symptoms pertaining to pulmonary and gastrointestinal involvement may be present. Manifestations of involvement beyond lung and intestine can be seen with dissemination of infection and lethal hyperinfection. Immunosuppression secondary to use of steroids or other immunosuppressants and coexistence of human T-lymphotropic virus type-1 are the known risk factors for dissemination and hyperinfection. Diagnostic modalities comprise stool examination, serology and molecular testing. Stool tests are inexpensive but are limited by low sensitivity, whereas serologic and molecular tests are more precise but at the expense of higher cost. Treatment with Ivermectin or Albendazole as an alternative is safe and efficacious. We present a rare case of acute pancreatitis secondary to Strongyloides. High index of suspicion in patients specifically from endemic countries of origin and lack of other common etiologies of acute pancreatitis may help in early diagnosis and prompt treatment of this potentially fatal infection.

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“…The right-sided colon is involved in most patients. Endoscopic findings in strongyloidiasis are numerous and include loss of vascular pattern, erythema, erosions, ulcerations, and the presence of yellowish-white nodules [1,3]. In the normal life cycle, free-living filariform larvae enter the skin and the parasitic life cycle begins.…”

Section: A)mentioning

confidence: 99%