New trends in diagnosis and treatment of chronic intestinal strongyloidiasis stercoralis in Egyptian patients

ABSTRACT

Strongyloidiasis, caused by strongyloides stercoralis, is diagnosis considered as a challenge to clinician and laboratory technician. Because the autoinfective larvae are difficult to eradicate one regimen dose may be insufficient and retreatment of patients on two occasions, at 1 and 2 months after the initial treatment dose was recommended. This retreatment regimen has yet to be proven in clinical trials. This study was performed on 24 patients who completed the study and having Strongyloides larvae in their stool obtained from Mansoura University Hospitals. Each stool sample was examined by direct saline smear, the formalinether sedimentation technique and agar plate culture patients were treated Mirazid double course for a month to be followed up by stool examination by traditional method and plate culture for three consecutive months. In this study five cases out of 24 were asymptomatic [20.8%]. Symptoms include abdominal manifestations as and vomiting [16.7%], epigastric pain and nausea [12.5], generalized abdominal pain [12.5%], chronic diarrhea [16.7%], irregular bowel habit [8.3%], and urticaria with abdominal pain [4.2%], Agar plate culture gave 100% positivity, even in cases were negative by coprological either direct smear and/or sediment tation technique. All cases were cured by Mirazid given for one month except there resistant cases. Only one cases responded to repeated course of Mirazid, while the other two cases still had larvae in their stool by agar culure plate. On combined therapy of both Mirazid and Mebendazole, larvae could be eliminated from their stool as approved by agar plate culture.