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At least 19 recordsLinked to original sources
PubMedDate not supplied

Imported strongyloidosis: a longitudinal analysis of 31 cases.

BACKGROUND: Attention regarding imported tropical diseases is typically focused on malaria, although other parasitic diseases such as strongyloidosis may also cause serious health problems. The importance of assessing clinical features and of proper diagnosis and treatment is presented on the basis of 31 patients with imported strongyloidosis. METHODS: A retrospective analysis was performed regarding patients treated for strongyloidosis in two referral centers in Switzerland from 1998 to 2002. RESULTS: Imported strongyloidosis was investigated in 12 travelers and 19 immigrants. The reasons for diagnostic work-up were clinical symptoms in 84% and eosinophilia and screening in each of 22.5%. All patients had a history of travel or residence in endemic areas. Initial therapy was effective in 20 patients, and there was a tendency for a better response to ivermectin compared with the response to other drugs. A significant reduction in blood eosinophil count and serologic antibody titer was observed in patients responding to therapy after an average of 96 and 270 days, respectively. CONCLUSIONS: Strongyloidosis must be suspected in travelers and immigrants with skin or abdominal symptoms from regions where Strongyloides stercoralis is highly endemic. The results of this case series confirm that ivermectin is the drug of choice in treating imported strongyloidosis. Response to therapy can be assessed by serology and differential white blood count performed over 6 months after therapy.

Adult↗
PubMed1995

[Strongyloidosis. Part II. Pathogenesis and pathology].

Pathogenesis and pathology of alimentary system of man infected with Strongyloides stercoralis are shown. Allergic, macroscopic lesions of duodenal, small and large intestinal walls, existing in different clinical strongyloidosis types are discussed. The role of endo-autoinfection in the course of strongyloidosis in the immunocompromised patients with fatal disseminated strongyloidosis is shown. In disseminated strongyloidosis lesions include stomach, liver and rarely pancreas. Pathogenesis of macroscopic and microscopic lesions in respiratory, circulatory and central nervous systems of a man infected with Strongyloides stercoralis, mainly in the course of fatal disseminated strongyloidosis, is shown. Rare cases of presence of parasite filariform larvae in urinary tract, reproductive system, and other organs are also given.

Animals↗
PubMed1999

Mortality associated with concurrent strongyloidosis and cytomegalovirus infection in a patient on steroid therapy.

Disseminated strongyloidosis has been recognized with increasing frequency, often in patients who are immunocompromised or have received steroid therapy. In addition, disease due to cytomegalovirus (CMV) is noted in immunodeficient hosts. We report on a 55-year-old Puerto Rican man who received steroid treatment for orpharyngeal pemphigus vulgaris and developed abdominal symptoms with alternating constipation and diarrhea. The clinical work-up did not reveal specific abnormalities, but the patient died of cardiopulmonary failure. At the postmortem examination, the patient had evidence of strongyloidosis and CMV disease. This report reviews both this case and the literature, and discusses the overlapping infections of strongyloidosis and CMV disease in this patient who had received steroid therapy.

Anti-Inflammatory Agents↗
PubMed2002

[Autochthonous strongyloidosis in an 81-year-old woman].

Strongyloidosis is an parasitic disease, caused by an intestinal nematode endemic in tropic and subtropic regions. In Central Europe it occurs only sporadically. The infective larvae in the soil penetrate the human skin. Following circulation through the lungs the larvae settle in the small intestine and mature into adult worms. Chronic strongyloidosis recurring up to 15 years is possible through endogenous autoinfection. Clinical feature of the disease are gastrointestinal symptoms, hypereosinophilia and skin rashes. We describe the case of an 81-year-old woman who presented with scaly exanthema, fever and perianal fistulation. A microscopic examination of a stool sample demonstrated filariform larvae of Strongyloides stercoralis. An autochthonous mode of infection was assumed. After starting treatment with mebendazole eosinophilia and rash gradually disappeared. The laboratory finding of eosinophilia in patients with gastrointestinal symptoms or exanthema should prompt the differential diagnosis of a parasitosis. Stool examination is necessary to find rare autochthonous infections by intestinal nematodes. Pathogenesis, clinical manifestation and treatment of strongyloidosis are discussed along with the clinical picture.

Aged↗
PubMed1997

Cure by ivermectin of a chronic, persistent, intestinal strongyloidosis.

A report is given of a cure by ivermectin of a 19-year-old patient with chronic, persistent, 3-year-old intestinal strongyloidosis resistant to several dosage regimens of conventional anthelminthics, including the current drug of choice for strongyloidosis thiabendazole and its therapeutic alternative, albendazole. Ivermectin was administered, first as a single, oral dose of 200 micrograms/kg with consequent reduction in larval output, but no complete parasitological cure. A second course of ivermectin, 200 micrograms/kg administered for two consecutive days, resulted in complete parasitological cure, as evidenced by the absence of Strongyloides stercoralis larvae in stool samples examined through the kato thick smears, Baermanns concentrations as well as in the 'enterotest' performed on jejunal fluid. The patient has remained parasitologically cured, after 7-months follow-up. Ivermectin was well tolerated with mild clinical and biochemical reactions which did not last for long.

Adult↗
PubMedDate not supplied

Prospective study of strongyloidosis in patients with hematologic malignancies.

Immunocompromised individuals infected with Strongyloides stercoralis may develop severe hyperinfection or disseminated disease with high mortality. Patients with hematological malignancies are at risk because of immunodepression produced either by the disease or its treatment. A prospective study was undertaken at the Hospital de Clínicas de Porto Alegre, from July 1994 to July 1995. Seventy-two (HIV negative), had 3 stool samples collected at different days and had not received recent anthelmintic therapy. Larvae, isolated in a modified Baermann method, were found in 6 patients, with a resultant prevalence of 8.3%. No complicated strongyloidosis was documented. The positive result for S. stercoralis larvae was significantly associated (p < 0.001) with eosinophilia. Knowledge of prevalence figures and incidence of severe disease is important to adequate guidelines for empirical treatment besides the rigorous search for strongyloidosis in patients with hematological malignancies.

Adolescent↗
PubMed1999

Fatal strongyloidosis following corticosteroid therapy in a patient with chronic idiopathic thrombocytopenia.

A patient with chronic idiopathic thrombocytopenia and fatal strongyloides hyperinfection syndrome following prolonged corticosteroid therapy is briefly described. Diagnosis was difficult to perform due to absence of eosinophilia and diarrhea at presentation, as well as to the negativity of multiple stool specimens examined by direct microscopy of saline smear, formol-ether concentration techniques, and Baermann's test. The striking hypoalbuminemia in the setting of the normal results of liver function tests and prothrombin time was assumed to be due to enteropathy. Therefore, an upper endoscopy was undertaken, revealing Strongyloides stercoralis (SS) larvae in the biopsy specimens of the gastric and duodenal mucosa. The SS larvae were also demonstrated in the multiple specimens of the concentrated sputum. Despite thiabendazol treatment, death ensued. On autopsy, SS larvae were recovered in the gastrointestinal tract and lungs. The importance of early diagnosis and of ruling out strongyloidosis prior to administration of corticosteroids are discussed, as well as the pathogenetic aspects of strongyloidosis in the patient under corticosteroids.

Adrenal Cortex Hormones↗
PubMed2002

[Strongyloidosis. Part IX. Treatment].

The treatment of chronic and massive (uncomplicated) and severe (complicated) disseminated strongyloidosis, was presented from the historical point of view. The sequence of achievements in regard of treatment of the gentian violet, dithiazine iodide, benzimidazoles (thiabendazole, mebendazole, albendazole, cambendazole), ivermectin and cyclosporin A, was described. The recommendations for treatment of strongyloidosis are also given.

Albendazole↗
PubMed1988

[Prurigo and further diagnostically significant skin symptoms in strongyloidosis].

An increasing incidence of strongyloidosis must be expected in European countries as a result of the increasing numbers of immigrants, as well as holiday-makers returning from tropical regions. In addition to gastrointestinal symptoms, dermatological complaints are predominant. Only rarely are cutaneous symptoms the only clinical manifestation of disease. The penetration of filariform larvae may cause "ground itch." In cases of chronic disease, larva currens is the most obvious sign and consists of linear urticarial wheals evoked by larva migration. The most common non-specific symptoms are rashes, pruritus and urticaria. A further symptom of strongyloidosis, intensely itching prurigo, is described in a 20-year-old female Thai. Remission was achieved following tiabendazole therapy.

Adult↗
PubMed1996

[Strongyloidosis. IV. Immunodiagnosis].

Excretory-secretory and somatic antigens from Strongyloides stercoralis and other parasitic species of nematodes used in intradermal test and serological assays in strongyloidosis were described. Detection of specific IgA, IgE, IgG and IgM antibodies in the serodiagnosis of human strongyloidosis was also described.

Animals↗
PubMed2000

[Strongyloidosis. Part VII. Epidemiology and prevention (2)].

The formation of Strongyloides stercoralis infections in the tropical countries and in the temperate climatic zone, with special attention to the factors and the high risk groups, were described. The concurrent infections, prevention and control of strongyloidosis was also presented.

Animals↗
PubMed2000

[Strongyloidosis. Part VII. Epidemiology and prevention (1)].

The source of invasion of Strongyloides stercoralis and the routes of transmission strongyloidosis were presented. The survival, development and behavior forms parasitic and free-living generation of S. stercoralis in soil and host was also described.

Animals↗
PubMed1994

[Organ changes in experimental strongyloidosis of rabbits provoked by Strongyloides papillosus].

Strongyloidosis was induced by percutaneous injection of rabbits; then organ changes were tested. It has been found that Strongyloides papillosus evoked changes in intestine, liver, kidney and lung. No notable changes were found in heart, spleen and suprarenal gland. These changes may be provoked not only directly by the presence of these parasites but also by the products of metabolism of S. papillosus.

Animals↗
PubMed1996

[Strongyloidosis. II. Clinical manifestations].

Clinical manifestations of chronic, uncomplicated and severe, complicated disseminated strongyloidosis of a patient infected with Strongyloides stercoralis are shown. Cutaneous, gastrointestinal, hepatobiliary, pulmonary, rheumatic, neurological, psychiatric symptoms, as well as those of genitourinary, and cardiovascular systems and other clinical manifestations are discussed.

Adult↗
PubMed1997

Overwhelming strongyloidosis in a foal.

A 6-month-old foal was evaluated because of weakness, weight loss, and inappetence of 3 weeks' duration. On initial examination, the foal was weak, poorly responsive, and emaciated. Clinicopathologic abnormalities included anemia and hypoproteinemia. Because of its severe debilitation, the foal was euthantized. Necropsy revealed marked infection of the small intestine with Strongyloides westeri and severe edema of the entire gastrointestinal tract. The foal had been orphaned when it was 6 hours old and raised in isolation from other horses. We believe that this foal developed overwhelming strongyloidosis when it was first exposed to other foals at 5 months of age, because it had not been naturally exposed to the organism at a younger age and was immunologically naive.

Animals↗