Evaluation of Three Methods for Laboratory Diagnosis of Strongyloides stercoralis Infection

Kaminsky, Rina Girard de

doi:10.2307/3283519

Cited by 95 publications

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“…15 In another study performed to evaluate the cost-effectiveness in recovering S. stercoralis larvae, the direct smear, a modified Baermann technique and the agar plate culture method were compared, being the last 4.4 times more sensitive than the others. 12,13 The agar plate culture is not routinely performed in all laboratories to diagnose this enteroparasitosis. Results presented here reinforce the convenience to introduce this assay, or a similarly sensitive method, to search for S. stercoralis in patients with eosinophilia and past risks of infection, who presently live outside of endemic areas.…”

Section: Discussionmentioning

confidence: 99%

“…The latest, proved to be the best to detect S. stercoralis infection. [10][11][12][13][14][15] Serology is also used for screening and diagnosis out of endemic areas. [16][17][18] In hyperinfection and disseminated strongyloidosis, patients are usually symptomatic and parasitological diagnosis is easy, because larvae are frequently found in stool, sputum, and even in other samples (ascitic fluid, bronchoalveolar lavage).…”

Section: Introductionmentioning

confidence: 99%

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High Rate of Strongyloidosis Infection, Out of Endemic Area, in Patients with Eosinophilia and without Risk of Exogenous Reinfections

Repetto¹,

Durán²,

Lasala³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Strongyloides stercoralis chronic infections are usually asymptomatic and underestimated. We used direct fresh stool examination, Ritchie's method, and agar plate culture for diagnosis in patients with eosinophilia and previous residence in endemic areas. The frequency of strongyloidosis detected among these patients was high: 21 of 42 were positive. Among them, 10 were positive only by agar plate culture. After ivermectin treatment, patients resulted negative for parasitological tests and reduced their eosinophil counts. Half of the submitted patients that were followed 4–12 months after treatment remained negative without eosinophilia, except one who showed an eosinophil ascending curve before reappearance of larvae in stools. The high frequency of strongyloidosis found in this group emphasizes the relevance of including this parasitosis among differential diagnosis in patients with eosinophilia and past risk of S. stercoralis infection to prevent disseminated infections secondary to corticoid therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High Rate of Strongyloidosis Infection, Out of Endemic Area, in Patients with Eosinophilia and without Risk of Exogenous Reinfections

Repetto¹,

Durán²,

Lasala³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…La utilización del método de Baermann y el en placa de ágar ha sido frecuente en el diagnóstico de S. stercoralis 24,[30][31][32] y múltiples estudios han comparado su utilidad diagnóstica y la de otros métodos, como el examen directo en heces y la concentración formol-éter 33 . La mayoría de las investigaciones solo evalúan la validez diagnóstica en términos de sensibilidad y especificidad del método, lo que resulta limitado en la medida en que estos parámetros no son suficientes para la toma de decisiones clínicas, al obstar otros criterios relevantes en la evaluación de pruebas diagnósticas, tales como el desempeño, la eficiencia y la seguridad.…”

Section: Introductionunclassified

Infección por Strongyloides stercoralis: metanálisis sobre evaluación de métodos diagnósticos convencionales (1980-2013)

Campo-Polanco

Gutiérrez

Arias

2014

Rev. Esp. Salud Publica

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(*) El presente trabajo es un producto derivado del desarrollo de la propuesta de investigación "Diagnós-tico molecular de Estrongiloidiasis mediante PCR en tiempo rea. Comparación con métodos de diagnós-tico tradicionales" aprobado por el Centro de Investigación para el Desarrollo y la Innovación (CIDI), Universidad Pontificia Bolivariana. Medellín. Colombia en la convocatoria XIV. código interno de radicado 175-11/11 935A. Sin conflicto de intereses RESUMENFundamentos: Las investigaciones sobre los métodos diagnósticos de estrongiloidiasis presentan divergencias en su validez y son incompletas al no reportar datos sobre seguridad, eficiencia y desempeño diagnós-tico. El objetivo del trabajo fue evaluar la validez, desempeño, eficiencia y seguridad diagnósticas de cuatro métodos parasitológicos convencionales para la detección de la infección por Strongyloides stercoralis. Métodos:Revisión sistemática con metanálisis, búsqueda exhaustiva y reproducible de literatura en seis bases de datos para el período 1980-2013. Se evaluó la calidad de los artículos y se realizó metanálisis con el modelo de efectos aleatorios, calculando sensibilidad, especificidad, cocientes de probabilidad, valores predictivos, proporción de resultados falsos, exactitud, razón de odds, índice J de Youden y curva ROC, usando Meta-DiSc(es) y Epidat 3.1.Resultados: Se incluyeron 11 estudios con 9.025 individuos. La sensibilidad del método de Baermann fue del 72%, cociente de probabilidad positivo (CP+) 228 y cociente de probabilidad negativo (CP-) 0,32. El en placa de ágar (CPA) presentó una sensibilidad de 89%, CP+ 341 y CP-0,11. En el examen directo en heces la sensibilidad fue del 21%; el CP+ 67 y el CP-0,67. La sensibilidad de la concentración formol-éter fue del 48%, el CP+ 110 y el CP-0,59. Áreas bajo la curva ROC de 0,999 en Baermann y CPA; 0,977 en el examen directo en heces y 0,829 en concentración formol-éter; la especificidad fue de 100% en todas las pruebas. Conclusiones:Los cuatro métodos parasitológicos convencionales evaluados en este estudio para la detección de S. stercoralis pueden ser útiles, sin embargo, resulta más idóneo implementar el en placa de ágar y el método de Baermann.

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“…Hastadan üç gün üst üste alınan dışkı örneğinin incelenmesinde de hiçbir parazite rastlanmadığı, Baermann metodu ile Strongyloides stercoralis larvalarının saptandığı, uygulanan albendazol tedavisinde (400 mg/gün) hastanın durumunun genel olarak düzeldiği ve tedavi sonrası yapılan dışkı incelemesinde parazite rastlanmadığı bildirilmiştir (4). İmmünkompetan hastalarda larvanın araştırılması için direkt yaymadan en az dört kat daha etkili olan agar plak kültürünün en yüksek sensitiviteye (%96) sahip olduğu gösterilmiştir (13,14). Tanıdan şüphelenildiğinde dışkıda parazit incelemesi yapılabilir.…”

Section: Strongyloidiasis S Stercoralis'inunclassified

Strongyloidosis Caused Loeffler's Syndrome in an Immunosuppressed Patient Who Uses Cronic Steroid

Ekmekci¹,

Tahmaz²,

Altıparmak³

et al. 2013

TurkiyeParazitolDerg

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ÖZETStrongyloides strecoralis tüm dünyada on milyonlarca insanı enfekte eden bir insan barsak nematodudur. Ülkemizde nadiren görülmektedir. İmmün yetmezlikli hastalarda dissemine strongyloidiosis enfeksiyonu gelişebilir. S. stercoralis hiperenfeksiyonu sıklıkla enterik organizmalar ile oluşan menenjit veya sepsise eşlik eder. Glukokortikoid tedavisi hiperenfeksiyonu tetikleyen en sık durumlardan birisidir fakat hematolojik maligniteler, malnutrisyon ve AİDS ile ilişkili vakalar bildirilmektedir. İvermektin gibi antihelmintik ajanlar hiperenfeksiyon sendromunu tedavide başarı ile kullanılmaktadır. Biz burada uzun süredir steroid kullanan ve akciğerde kitle öntanısı ile tetkik edilen 82 yaşındaki bir hastada saptanan S. stercoralis enfeksiyonu ve Loeffler sendromlu bir olguyu sunuyoruz. Hasta göğüs hastalıkları kliniğinde sağ akciğer üst lobda kitle görüntüsü nedeniyle tetkik edilirken, karın ağrısı, diare ve kaşıntı şikayetlerinin olması üzerine tarafımıza yönlendirilmişti. Periferik yaymasında %43 eozinofili görüldü. Gaitanın parazitolojik incelemesinde Strongyloides stercoralis larvaları görüldü. Hastada parazitoz ve loeffler sendromu olabileceği düşünüldü. Albendazol tedavisi sonrası hastanın şikayetlerinde önemli ölçüde gerileme izlendi. (Turkiye Parazitol Derg 2013; 37: 55-7) Anahtar Sözcükler: Strongyloides stercoralis, kronik diyare, Loeffler sendromu Geliş Tarihi: 11.01.2012Kabul Tarihi: 12.01.2013 ABSTRACTStrongyloides stercoralis is an intestinal nematode of humans that infects tens of millions of people worldwide. It is a rarely reported parasitic infestation in Turkey. Disseminated strongyloidiosis may develop in patients with immunodeficiencies. S. stercoralis hyperinfection is often accompanied by sepsis or meningitis with enteric organisms. Glucocorticoid treatment is one of the conditions most specifically associated with triggering hyperinfection, but cases have been reported in association with hematologic malignancy, malnutrition, and AIDS. Anthelminthic agents such as ivermectin have been used successfully in treating the hyperinfection syndrome. We report a case of Strongiloides stercoralis infection and Loeffler syndrome that developed in a patient who had systemıc prednisolone. Thepatient in the pulmonary disease department clinic was examined because of right lung upper lobe mass image, and referred to us with complaints of abdominal pain, diarrhea and pruritus. Peripheral smear showed 43% eosinophilia. Parasitological examination of faeces showed larvae of Strongyloides stercoralis. Parasitosis and Loeffler's syndrome was considered in the patient. Thepatient's complaints declined significantly after treatment with albendazole. (Turkiye Parazitol Derg 2013; 37: 55-7)

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Evaluation of Three Methods for Laboratory Diagnosis of Strongyloides stercoralis Infection

Cited by 95 publications

References 0 publications

High Rate of Strongyloidosis Infection, Out of Endemic Area, in Patients with Eosinophilia and without Risk of Exogenous Reinfections

High Rate of Strongyloidosis Infection, Out of Endemic Area, in Patients with Eosinophilia and without Risk of Exogenous Reinfections

Infección por Strongyloides stercoralis: metanálisis sobre evaluación de métodos diagnósticos convencionales (1980-2013)

Strongyloidosis Caused Loeffler's Syndrome in an Immunosuppressed Patient Who Uses Cronic Steroid

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