Strongyloides stercoralis: the most prevalent parasitic cause of eosinophilia in Gilan province, northern Iran

Eosinophilia occurs in a wide variety of situations such as parasitic infections, allergic disorders, and malignancies. Most cases of eosinophilia of parasitic origin, especially those with a tissue migration life cycles consists of human infections by helminth parasites. The aim of present study was to determine the parasitic causes of eosinophilia in patients in a major endemic area of human fascioliasis in Gilan Province, northern part of Iran. One hundred and fifty patients presenting with an elevated eosinophilia attending infectious disease clinics with or without clinical symptoms, were examined. After clinical history evaluation and physical examination, coprological examinations were performed using the formalin-ether and the Kato-Katz techniques for detection of Fasciola sp. and intestinal parasites. Forty two percent of patients were infected with S. stercoralis, nine [6%] were found to be infected with Fasciola sp. while only a single patient [0.7%] were infected by Ttrichostrongylus sp. Local clinicians in Gilan may consider eosinophilia as a suggestive indication for diagnosis of human fascioliasis, especially when microscopic stool and/or serological tests are negative. Based on the results, local physicians should consider S. stercoralis as the potential causes of eosinophilia in patients with elevated eosinophilia

Disseminated strongyloidiasis successfully treated with extended duration ivermectin combined with albendazole: a case report of intractable strongyloidiasis.

We describe a patient with an overlapping syndrome disseminated strongyloidiasis and gram-negative sepsis. She was previously treated with albendazole 400 mg/day 14 days before admission without success. This admission, she was treated with a combination of oral ivermectin (injectable solution form), with a dosage of 200-400 microg/kg/day, and albendazole for 14 days. Strongyloides larvae disappeared from the stool by day 4 and from the sputum by day 10. No side effects were encountered during hospitalization or at the 1-month follow-up visit.

Inmunodiagnóstico de las infecciones por Strongloides stercoralis en Chile utilizando la prueba de ELISA / Immunodiagnosis of Strongyloides stercoralis infections in Chile using ELISA test

BACKGROUND: Strongyloides stercoralis is a world wide distributed small intestinal nematode parasite. In immunocompetent individuals S stercoralis can produce asymptomatic infections or a moderate clinical picture of diarrhea, some cases become chronic. In immunocompromised patients, a disseminated disease may appear, sometimes fatal. In Chile, there is little epidemiological information about S stercoralis infections and appropriate diagnostic techniques are usually not used. AIM: To evaluate the yield of an ELISA test for the diagnosis of strongyloidiasis in Chilean patients. MATERIAL AND METHODS: Ten serum samples from patients with S stercoralis infections confirmed by a positive stool examination, 66 samples from individuals with other infections by tissue helminthes (24 toxocariasis, 15 trichinellosis, 11 hydatidosis, 12 fascioliasis and 4 cysticercosis), 13 samples from subjects with autoimmune diseases and 49 samples from apparently healthy individuals with a normal eosinophil count, were studied. ELISA antigen was prepared using a filariform larval extract obtained from a murine species of Strongyloides, maintained in laboratory animals. RESULTS: Using 0.33 optical density units as a cut off value, 9 of 10 sera of S stercoralis infected individuals, had a positive ELISA test. No cross reactions were observed with sera of patients with other helminthic infections, autoimmune diseases or in healthy individuals. Thus, specificity, positive and negative predictive values were 100 per cent. CONCLUSIONS: The results obtained are similar with those found by other investigators. ELISA test for strongyloidiasis is a useful tool for the diagnosis of clinical cases and for seroepidemiological studies of this nematode infection in Chile.

Persistent infection with Strongyloides venezuelensis in the Mongolian gerbil (Meriones unguiculatus)

To examine the fate of Strongyloides venezuelensis. Mongolian gerbils (Meriones unguicalatus) were orally infected with 1,000 L3 larvae per animal. Altogether, 50 gerbils divided into 5 groups of 10 each were monitored for a period of 570 days to document the kinetics of faecal egg output, adults worm population, morphological development, fecundity, and hematological changes including peripheral blood eosinophilia. This study chronicled a life long parasitism of S. venezuelensis in the gerbil host, and showed that S. venezuelensis infection was quite stable throughout the course of infection and the worms maintained their normal development as evidenced by their body dimension. A progressive loss of body condition of the infected gerbils was observed as the level of infection advanced. However, no detectable pathological changes were observed in the gastrointestinal tract. The present findings indicate that an immunocompetent host, such as the Mongolian gerbil, can serve as a life long carrier model of S. venezuelensis if the worms are not expelled within 570 days after infection.

Coinfection by Strongyloides stercoralis in blood donors infected with human T-cell leukemia/lymphoma virus type 1 in Sao Paulo city, Brazil

The frequency of coinfection with Strongyloides stercoralis and human T-cell leukemia/lymphoma virus type 1 (HTML-1) was determined in 91 blood donors examined at the blood bank of a large hospital in Sao Paulo city, Brazil. As control group 61 individuals, not infected by HTLV-1, were submitted to the same techniques for the diagnosis of S. stercoralis infection. In HTLV-1 infected patients the frequency of S. stercoralis infection was 12.1 percent; on the other hand, the control group showed a frequency significantly lower of S. stercoralis infection (1.6 percent), suggesting that HTLV-1 patients shoud be considered as a high risk group for strongyloidiasis in Sao Paulo city.

Serodiagnosis of strongyloidiasis: the application and significance

O diagnostico parasitologico baseado no exame de fezes e muitas vezes dificil, principalmente nos casos de infeccoes cronicas ou leves pelo S. stercoralis. Mesmo utilizando o mais novo e sensivel metodo (cultura em placas de agar) e essencial examinar repetidamente as amostras fecais, para um diagnostico correto. E importante ressaltar tambem que o resultado negativo nao indica de modo inequivoco a ausencia da infeccao. Por outro lado, varios sorologicos recentementes desenvolvidos para estrongiloidiase tem provado a sua eficacia quando usados para complementar exames parasitologicos. Para demonstrar infeccao por Strongyloides desenvolvemos dois tipos de testes sorologicos - ELISA e GPAT - e, com base em nossos recentes estudos, apresentamos uma opiniao sobre sua possivel aplicacao para screening em massa, estudos epidemiologicos e avaliacao pos-tratamento de estrongiloidiases.

Strongyloidiasis en Santa Clotilde (Río Napo): uso de la técnica de Baermann modificado en copa para heces y esputo / Strongyloidiasis in Santa Clotilde (Río Napo): use of modified Baermann's techonique in cup in feces and sputum

Se realizó un estudio prospectivo entre Octubre y Noviembre de 1991 en el pueblo de Santa Clotilde (Río Napo) - Región del Amazonas (antes Loreto) a fin de determinar la presencia de Strongyloidiasis. Para ello se escogieron 237 personas al azar (sus muestras de heces y esputo fueron procesadas mediante la Técnica de Baermann), de ellos 45 (19 por ciento) presentaron Strongylides en heces y sólo 1 (2.2 por ciento) fue positivo en esputo. El 62 por ciento de los afectados fueron mujeres y el resto varones. El grupo preponderante (71 por ciento) estuvo entre 1m-19a. El segundo exámen de heces usando la Técnica de Baermann fue muy importante pues detectó el 24 por ciento (11/45) de nuestros casos que fueron negativos en el 1er. exámen. El exámen directo sólo fue positivo en el 15.6 por ciento (7/45) de nuestros pacientes positivos a Strongyloides. El 20 por ciento de nuestros pacientes fueron asintomáticos, de los sintomáticos la molestia principal fue dolor abdominal que fue el más preponderante, también hubo presencia de náuseas, diarreas y vómitos. Los síntomas pulmonares (tos y/o disnea estuvieron presentes en el 47 por ciento. Al exámen el hallazgos más saltantes fue palidez en el 80 por ciento (36/45)