Disease X Testing: The results of an international external quality assessment exercise

The United Nations Secretary-General Mechanism (UNSGM) for investigation of the alleged use of chemical and biological weapons is the only established international mechanism of this type under the UN. The UNGSM may launch an international investigation, relying on a roster of expert consultants, qualified experts, and analytical laboratories nominated by the member states. Under the framework of the UNSGM, we organized an external quality assurance exercise for nominated laboratories, named the Disease X Test, to improve the ability to discover and identify new pathogens that may cause possible epidemics and to determine their animal origin. The "what-if" scenario was to identify the etiological agent responsible for an outbreak that has tested negative for many known pathogens, including viruses and bacteria. Three microbes were added to the samples, Dabie bandavirus, Mammarenavirus, and Gemella spp., of which the last two have not been taxonomically named or published. The animal samples were from Rattus norvegicus, Marmota himalayana, New Zealand white rabbit, and the tick Haemaphysalis longicornis. Of the 11 international laboratories that participated in this activity, six accurately identified pathogen X as a new Mammarenavirus, and five correctly identified the animal origin as R. norvegicus. These results showed that many laboratories under the UNSGM have the capacity and ability to identify a new virus during a possible international investigation of a suspected biological event. The technical details are discussed in this report.Copyright © 2022

Anti-SARS-CoV-2 antibodies important in diagnostics of acute hepatitis in children

The most common causes of acute hepatitis in children are hepatitis A and autoimmune hepatitis. Hepatitis in the course of Wilson's disease is sporadically registered in adolescents. An increase of activity of aminotransferases both in the course of multisystem inflammatory syndrome in children (MIS-C) and in the course of COVID-19 has been observed. Hepatitis is common in children with MIS-C and is associated with a more severe presentation and persistent elevation of liver function tests. To date, no cases of acute hepatitis in children due to COVID-19 have been reported. We present 2 cases of acute hepatitis in children where the only cause seems to be a previous asymptomatic SARS-CoV-2 infection.Copyright © 2023 Termedia Publishing House Ltd.. All rights reserved.

The impact of COVID-19 epidemic on the control of important parasitic diseases.

The spread of COVID-19 has increased the risk of contact transmission between people, and imposes challenges and opportunities for the prevention and control of important parasitic diseases. There may be risks of COVID-19 infection during the implementation of the virus control, including in field investigation and intervention, contacting with fecal samples, or with asymptomatic infected people. Therefore, corresponding prevention and control measures should be taken before and during field investigation, and in sample transportation and detection to prevent the risks effectively. In this paper, the risks and corresponding countermeasures in the above processes are discussed in detail, and the opportunities that COVID-19 brought to the disease control system are also analyzed.Copyright © 2021, National Institute of Parasitic Diseases. All rights reserved.

Pseudomembranous colitis in patients with COVID-19 (review)

AIM: to estimate the features of pseudomembranous colitis in patients with COVID-19, diagnostics, conservative treatment and surgery for complications. PATIENTS AND METHODS: a retrospective analysis of 396 patients with pseudomembranous colitis (PMC) in patients with new coronavirus infection was carried out for the period from March 2020 to November 2021. Among them there were 156 (39.3%) males, females - 240 (60.6%), moderate and severe forms of COVID-19 occurred in 97.48%. The diagnosis of PMC was established due to clinical picture, laboratory, instrumental methods (feces on Cl. difficile, colonoscopy, CT, US, laparoscopy). RESULT(S): the PMC rate in COVID-19 was 1.17%. All patients received antibiotics, 2 or 3 antibiotics - 44.6%, glu-cocorticoids were received by all patients. At 82.8%, PMC developed during the peak of COVID-19. To clarify the PMC, CT was performed in 33.8% of patients, colonoscopy - 33.08%, laparoscopy - in 37.1% (to exclude bowel perforation, peritonitis). Conservative treatment was effective in 88.8%, 76 (19.1%) patients had indications for surgery (perforation, peritonitis, toxic megacolon). Most often, with peritonitis without clear intraoperative confir-mation of perforation, laparoscopic lavage of the abdominal cavity was performed (60 patients - 78.9%, mortality - 15.0%), colon resection (n = 6 (7.9%), mortality - 66.6%), ileo-or colostomy (n = 8 (10.5%), mortality - 37.5%), colectomy (n = 2 (2.6%), mortality - 50.0%). The overall postoperative mortality rate was 22.4%, the incidence of surgical complications was 43.4%. In addition, in the postoperative period, pneumonia was in 76.3%, thrombosis and pulmonary embolism in 22.3% of patients. In general, the overall mortality in our patients with PMC was 11.4%, with conservative treatment - 8.8%. CONCLUSION(S): pseudomembranous colitis is a severe, life-threatening complication of COVID-19. In the overwhelm-ing majority of patients, conservative therapy was effective, but almost 1/5 of patients developed indications for surgery, the latter being accompanied by high mortality and a high morbidity rate. Progress in the treatment of PMC, apparently, is associated with early diagnosis, intensive conservative therapy, and in the case of indications for surgery, their implementation before decompensation of the patient's condition and the development of severe intra-abdominal complications and sepsis.Copyright © 2022, Association of Coloproctologists of Russia. All rights reserved.

Development of PCR diagnostic method for Trichomonas foetus infection based on 18S rRNA.

To establish a PCR detection method for Trichomonas foetus, the primers were designed and synthesized according to the 18S rRNA gene sequence of T. foetus published by GenBank. The positive recombinant plasmid pUCm-T-TF18S of T. foetus was used as the template, and the genomic DNA of Giardia felis, Coccidia +e-lis, feline parvovirus and cDNA of feline coronavirus were used as the control for PCR detection to analyze the specificity of this method. The positive T. foetus recombinant plasmid was serial to 8 different concentrations with a gap of 10 folds, and PCR was performed to analyze the sensitivity of this method. The pUCm-T-TF18S plasmids stored at -20 " for 3, 6, 9 and 12 months were detected by PCR to analyze the stability of the method. Twenty cat fecal samples were tested using this established PCR assay and compared with those of microscopic examination. The results showed that the recombinant plasmid pUCm-T- TF18S gave specific bands after PCR amplification. The sequencing results showed that the length of the product sequence was 1 264 bp, and the BLAST sequence comparison analysis showed 99.53% sequence identity, which is consistent with that of T. foetus from cats (GenBank registration number M81842.1). The PCR method for detection of T. foetus had no cross-reactivities with C. felis, G. felis, feline coronavirus and feline parvovirus;the minimum detectable template concentration is 4.52 X 105 copies/xl;The target band of T. foetus DNA can still be detected after being stored in the refrigerator at -20 " for 12 months. This method detected 16 positive samples of T. foetus nucleic acid from 20 cat fecal samples, which is more accurate and sensitive than the results from traditional microscopy (13 samples). It is suggested that the PCR method for the detection of T. foetus is highly specific, sensitive and stable, and can be used for clinical detection and epidemiological investigation of T. foetus.Copyright © 2022, National Institute of Parasitic Diseases. All rights reserved.

Idiopathic anomalous congenital band causing small intestinal obstruction in a 5-month-old dog

A 5-month-old, intact male, yellow Labrador retriever was presented with a 24-hour history of anorexia and vomiting. Abdominal imaging revealed the presence of a mechanical obstruction in the jejunum and peritoneal effusion. Cytologic evaluation and culture of the effusion prior to surgery identified a suppurative exudate with bacteria consistent with septic peritonitis and suspected to be related to the intestinal lesion. An exploratory laparotomy was performed, and a segment of jejunum was circumferentially severely constricted by an off-white, fibrous band of tissue. Resection and anastomosis of the strangulated segment of jejunum and excision of the constricting band provided resolution of the clinical signs. The dog made a complete recovery. Histologic evaluation revealed the band to be composed of fibrovascular and smooth muscle tissue, consistent with an idiopathic anomalous congenital band. No other gastrointestinal lesions were observed, either grossly at surgery or histologically in the resected segment of intestine. To our knowledge, a similar structure has not been reported in the veterinary literature.Copyright © 2022 Canadian Veterinary Medical Association. All rights reserved.

Acute Diarrhea in Adults

Acute diarrheal disease accounts for 179 million outpatient visits annually in the United States. Diarrhea can be categorized as inflammatory or noninflammatory, and both types have infectious and noninfectious causes. Infectious noninflammatory diarrhea is often viral in etiology and is the most common presentation;however, bacterial causes are also common and may be related to travel or foodborne illness. History for patients with acute diarrhea should include onset and frequency of symptoms, stool character, a focused review of systems including fever and other symptoms, and evaluation of exposures and risk factors. The physical examination should include evaluation for signs of dehydration, sepsis, or potential surgical processes. Most episodes of acute diarrhea in countries with adequate food and water sanitation are uncomplicated and self-limited, requiring only an initial evaluation and supportive treatment. Additional diagnostic evaluation and management may be warranted when diarrhea is bloody or mucoid or when risk factors are present, including immunocompromise or recent hospitalization. Unless an outbreak is suspected, molecular studies are preferred over traditional stool cultures. In all cases, management begins with replacing water, electrolytes, and nutrients. Oral rehydration is preferred;however, signs of severe dehydration or sepsis warrant intravenous rehydration. Antidiarrheal agents can be symptomatic therapy for acute watery diarrhea and can help decrease inappropriate antibiotic use. Empiric antibiotics are rarely warranted, except in sepsis and some cases of travelers' or inflammatory diarrhea. Targeted antibiotic therapy may be appropriate following microbiologic stool assessment. Hand hygiene, personal protective equipment, and food and water safety measures are integral to preventing infectious diarrheal illnesses.Copyright © 2022 American Academy of Family Physicians.

Novel Coronavirus is the Only Virus Causing Childhood Invasive Diarrhea: A Case Series

Introduction: Typical manifestations of Coronavirus disease 2019 (COVID-19) include respiratory involvement. Gastrointestinal (GI) symptoms have also been reported as early clinical manifestations. The GI involvement can represent with diarrhea, vomiting, and abdominal pain. The present research aimed to identify dysentery as one of the signs of GI involvement in the novel coronavirus infection in children. Case Presentation: We report twelve patients with COVID-19 and dysentery. All these children had positive reverse transcriptionpolymerase chain reaction (RT-PCR) results. None had underlying illnesses or recent travel history. However, all children had contact with a first-degree relative affected by non-digestive COVID-19. In three patients, obvious dysentery was observed, and in the rest, red and white blood cells were evident in the stool exam. Stool exams were negative for bacterial infections, parasites, and the toxin of Clostridium difficile. Abdominal ultrasonography and echocardiographic evaluations to rule out multisystem inflammatory syndrome in children were normal. Supportive treatment, such as zinc supplementation and probiotics, was prescribed. They also received intravenous fluid therapy based on their dehydration percentage. In the end, they were discharged in good general condition without any complications. No GI complications were found in the follow-up series. Conclusion(s): Dysentery in children can be one of the GI manifestations of COVID-19, which is usually self-limiting. It does not require invasive diagnostic measures and antiviral treatments. This symptom is in contrast to other viral infections of the GI tract.Copyright © 2022, Author(s).

The Quinolone Resistance Genes in the Bacteriophage DNA Fractions in the Healthy Calf Stool Samples Via qPCR

The One Health approach shows that people, animals, plants, and environmental factors can affect each other. Phages are one of the mobile genetic elements. Quinolones are a critical group of antibiotics for both human and animal health and monitoring their antimicrobial resistance is very important. The aim of the study is to determine the frequency of the quinolone resistance gene in bacteriophage DNA fractions obtained from healthy calf stool samples. In our study, 50 samples from 6-9 months old calves, which were found to be healthy and not treated with any group of antibiotics in Sanliurfa province, were included. DNA isolation was made from phage lysates of stool samples and specific primers were used qnrA, qnrB and qnrS genes. qPCR was performed on LightCycler480. Despite not receiving any antibiotic treatment, qnrB was the most detected gene among the phage DNA fractions detected in 11 calves. While qnrA, qnrB and qnrS quinolone resistance genes were detected together in one sample, qnrB and qnrS resistance genes were found together in two samples. Our data, obtained from the study in Turkiye to search for antimicrobial resistance genes in phage fractions, showed the importance of the One Health approach and determined that it was highly effective in quinolone resistance gene shedding in healthy calves that had never been treated with antibiotics. It has been concluded that in empirical treatment with quinolone, attention should be paid to all living things and unconscious antibiotic use may cause the spread of resistance genes more than expected.Copyright © 2023, Veteriner Fakultesi Dergisi. All rights reserved.

Risk of COVID-19 in newborns depending on the infection course in the mother.

The incidence of the new coronavirus infection (COVID-19) remains a global problem worldwide. However, the effect of COVID-19 on the course of pregnancy and the possibility of intrauterine infection are insufficiently investigated. Recent studies suggest the possibility of a transplacental transmission of infection caused by SARS-CoV-2. Goal: To analyze SARS-Cov-2 RNA detection cases in newborns and to study possible factors influencing the infection of newborns from mothers with COVID-19. Materials and methods. From March to August 2020, there were 64 births to women with a confirmed diagnosis of COVID-19 at the Botkin's Infection Disease Hospital. In 15 newborns, the diagnosis of COVID-19 was laboratory confirmed. In this study, the histories of 14 newborns and their mothers were analyzed retrospectively. The diagnosis of COVID-19 was based on the detection of SARS-Cov-2 RNA in a nasopharyngeal swab or in fecal samples. Results. Analysis of the histories of mothers showed that 4 (28.6%) patients had an asymptomatic disease. Three (21.4%) women had a severe course of COVID-19, 7 (50%) patients had a course of moderate severity. Fetal hypoxia was more common in women with severe or moderate course of COVID-19. In 6 (42.7%) newborns, a positive nasopharyngeal swab was obtained within 48 hours after birth. None of the women whose children were RNA-positive in the first two days had a severe form of the disease, and two patients had an asymptomatic disease. Conclusion. 1. The frequency of detection of SARS-CoV-2 RNA in newborns from mothers with COVID-19 (under mother-child separation) was 21.9%. 2. Infection of a newborn with SARS-CoV-2 is possible both with a severe course of the disease in the mother and with an asymptomatic course. 3. A caesarean section does not exclude the possibility of a newborn infection with SARS-CoV-2. 4. In newborns, in most cases, an asymptomatic course of COVID-19 is observed.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Outbreak of Hemolytic-Uremic Syndrome in Children in Belarus: Epidemiology, Features of Clinical Course and Laboratory Changes, and Outcomes.

Introduction. Outbreaks of hemolytic uremic syndrome (HUS) have been described in many countries around the world, but no such information is available for Eastern European countries. Purpose. To determine clinical and laboratory differences, and to evaluate morbidity and outcomes during and outside the outbreak of HUS in children in Belarus. Materials and methods. A total o f 80 children diagnosed with HUS in 2021 in Belarus were included in the study;64 of them were admitted to the pediatric dialysis center in Minsk and divided into 2 groups: group 1 (29 children) - outside the HUS outbreak, and group 2 (35 children) - during the outbreak. In addition to standard laboratory tests, 52 children underwent stool analysis for Shiga toxin-producing Escherichia coli by real-time PCR (TaqMan Array Card). Results. The incidence of HUS in 2021 was 5.0/100 000 children <15 years (80 cases) and 10.6/100 000 children <5 years (59 cases). Boys were 52%, children <5 years old were 74%, patients with atypical HUS were 2.5%. Between 27.09.2021 and 29.10.2021 an outbreak of HUS was registered in 45 children, mostly from three country's regions: Minsk city - 17, Minsk region - 16 and Vitebsk region - 11. Patients of groups 1 and 2 did not differ in terms of age, 2.5 (1.6;5.1) and 3.6 (2.2;5.1) years, respectively, incidence of hemocolitis: 62% and 69%, respectively, baseline hemoglobin levels, 85 (77;99) and 102 (90;105) g/L, respectively, and platelet counts, 45 (25;71)x109/L and 53 (29;78) x109/L, respectively, need for dialysis, 79% and 57%, respectively, duration of anuria, 13 (7;16) and 12 (8;15) days, respectively, mortality, 3.4% (aHUS) and 2.9% (on the background of COVID-19), respectively, incidence of Shigatoxin-producing E. coli in faecal samples, 33% and 37%, respectively. The cause of HUS outbreak remained undetermined. Conclusions. Thus, the incidence of HUS in children in Belarus remains one of the highest in Europe. A national algorithm should be developed to detect the source of infection and to indicate and identify the pathogen in STEC infections.Copyright © 2022, Professionalnye Izdaniya. All rights reserved.

Outbreak of Hemolytic-Uremic Syndrome in Children in Belarus: Epidemiology, Features of Clinical Course and Laboratory Changes, and Outcomes.

Introduction. Outbreaks of hemolytic uremic syndrome (HUS) have been described in many countries around the world, but no such information is available for Eastern European countries. Purpose. To determine clinical and laboratory differences, and to evaluate morbidity and outcomes during and outside the outbreak of HUS in children in Belarus. Materials and methods. A total o f 80 children diagnosed with HUS in 2021 in Belarus were included in the study;64 of them were admitted to the pediatric dialysis center in Minsk and divided into 2 groups: group 1 (29 children) - outside the HUS outbreak, and group 2 (35 children) - during the outbreak. In addition to standard laboratory tests, 52 children underwent stool analysis for Shiga toxin-producing Escherichia coli by real-time PCR (TaqMan Array Card). Results. The incidence of HUS in 2021 was 5.0/100 000 children <15 years (80 cases) and 10.6/100 000 children <5 years (59 cases). Boys were 52%, children <5 years old were 74%, patients with atypical HUS were 2.5%. Between 27.09.2021 and 29.10.2021 an outbreak of HUS was registered in 45 children, mostly from three country's regions: Minsk city - 17, Minsk region - 16 and Vitebsk region - 11. Patients of groups 1 and 2 did not differ in terms of age, 2.5 (1.6;5.1) and 3.6 (2.2;5.1) years, respectively, incidence of hemocolitis: 62% and 69%, respectively, baseline hemoglobin levels, 85 (77;99) and 102 (90;105) g/L, respectively, and platelet counts, 45 (25;71)x109/L and 53 (29;78) x109/L, respectively, need for dialysis, 79% and 57%, respectively, duration of anuria, 13 (7;16) and 12 (8;15) days, respectively, mortality, 3.4% (aHUS) and 2.9% (on the background of COVID-19), respectively, incidence of Shigatoxin-producing E. coli in faecal samples, 33% and 37%, respectively. The cause of HUS outbreak remained undetermined. Conclusions. Thus, the incidence of HUS in children in Belarus remains one of the highest in Europe. A national algorithm should be developed to detect the source of infection and to indicate and identify the pathogen in STEC infections.Copyright © 2022, Professionalnye Izdaniya. All rights reserved.

Impact of COVID-19 on the digestive system: A descriptive cross-sectional study

Background: Various digestive symptoms caused by COVID-19 are frequently reported. This study aims to describe the most frequent digestive signs in patients with COVID-19, the relationship between the severity of digestive symptoms and some serological markers associated with liver manifestation, the detection of SARS-CoV-2 in a stool sample, and the mortality rate of those patients. Material(s) and Method(s): A descriptive cross-sectional study on 100 confirmed COVID-19 cases with digestive and hepatic manifestation in one center (Fallujah Teaching Hospital), Anbar governorate, Iraq, during a period of study. Questioner's data were formed for all patients regarding age, sex, and comorbidities such as diabetes and hypertension. Liver function enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, total bilirubin (TBIL), and direct bilirubin and haematological parameters such as ferritin D-dimer, C-reactive protein (CRP), albumin, amylase, leukocyte count, and prothrombin time were used. SARS-CoV-2 prevalence in stool is determined using reverse transcription polymerase chain reaction according to manufacturer's instructions. The mortality rate of patients with COVID-19 was also determined. Data were followed up until April 22, 2022. Result(s): Patients with digestive symptoms who had COVID-19 had an average age of 45.03 (SD 20.078), 52 (52%) were men, and 48 (48%) were women. No statistically significant variances were observed in the severity of digestive symptoms among age groups. The three digestive symptoms that patients with COVID-19 experienced most frequently were fatigue, fever, and abdominal colic. SARS-CoV-2 was detected in the stool of 11% of the patients with COVID-19 with digestive signs. The COVID-19 mortality rate was 9%. Statistically, significant variance was observed in ALT (P value 0.01) and TBIL (P value 0.0027) levels between mild, moderate, and severe gastrointestinal (GI) diseases. The levels of CRP varied considerably among those with mild, moderate, and severe GI conditions (P value 0.0182, according to the findings). In mild, moderate, and severe GI disorders, ferritin levels differed considerably (P value 0.05). Conclusion(s): The faecal sample with a nasopharyngeal swab is needed to confirm COVID-19 diagnosis;hepatic manifestations are connected with increased COVID-19 mortality in individuals with digestive symptoms.Copyright © 2022 Wahab, Khalil, Majeed, licensee HBKU Press.

Presence of SARS-CoV-2 on surfaces and materials in supermarket social areas in Türkiye

The aim of this study was to monitor the presence of SARS-CoV-2, the virus that cause the coronavirus disease 2019 (COVID-19), particularly on certain foods and surfaces that come in contact with food in district supermarkets in Ankara, Türkiye, where the highest number of COVID-19 cases was reported based on data from the Ministry of Health. For this purpose, a total of 172 samples were taken from 5 supermarkets in 4 districts in Ankara. RNA was extracted from the samples and RdRp gene-targeting reverse transcription quantitative polymerase chain reaction (RT-qPCR) assays were used to determine the presence of SARS-CoV-2. The results showed that all the supermarket samples collected during the period when there was a high number of COVID-19 cases in the district did not have SARS-CoV-2 except for one sample that was taken from a supermarket where COVID-19 had been detected among the staff. In this supermarket, COVID-19 RNA was detected with a high number of copies of 5 000, using Real-Time RT-PCR assay in pooled swab samples taken from salt shakers, pepper shakers, red pepper shakers, and vinegar and oil bottles in the social area that the staff used for lunchbreaks and other breaks. This finding shows that it is of great importance for public health agencies to monitor COVID-19 cases in food businesses in regions with a high number of cases and to take samples from these businesses at certain intervals, as a form of "early warning system.”. © 2023, Ankara University. All rights reserved.

Colorectal cancer screen-up-to-date: 10-year prevalence in a regional safety-net health system

Introduction: Colorectal cancer (CRC) screening is an effective secondary prevention method with an increased probability of diagnosing CRC at an earlier stage, and a consequent improvement in survival post-treatment. This is especially true for individuals who undergo guideline recommended screening at appropriate intervals. Studies have reported a consistent rise in long-term trends of guideline-adherent screen-up-to-date (SUTD) rates among predominantly White and insured individuals. Here we use longitudinal data from 2011-2020 and report 10-year prevalence and correlates of CRC SUTD among patients in a safety-net health system. Method(s): All patients aged 50-74 years who had a primary care encounter in any of the 12 community clinics in a large county safety-net health system were included. An individual was considered to be SUTD if he/she had a stool test during the calendar year, flexible sigmoidoscopy in the past 5 years, or colonoscopy in the past 10 years. To obtain a population health estimate (and not only examine frequencies), we included in the denominator patients with a primary care visit in the past 3 years. Multivariable generalized estimating equations (GEE) model was used to examine the association of SUTD status with time-varying demographic and clinical characteristics over the 10-year period. Result(s): Our analytical cohort had 50,647 patients in 2011, of which 40.9% (20,708) patients were SUTD. Annual rates of SUTD were largely unchanged until 2019, when the prevalence increased to 46.8% after initiation of a population health outreach mailed FIT program. The SUTD rate fell to the baseline level of 40.8% in 2020 after the pandemic-induced suspension of the mailed FIT program. Multivariable GEE model demonstrated that older patients, females, and Hispanics had higher odds of being SUTD compared to younger patients, males, and non-Hispanics, respectively. Additionally, patients who had prior interaction with the healthcare system (had prior stool tests or prior primary care encounters) had higher odds of being SUTD than those with no prior experience with the healthcare system (no prior stool tests or no prior primary care encounters). Conclusion(s): This study establishes contemporary evidence about the 10-year prevalence and correlates of CRC SUTD status among patients in a safety-net health system. Prevalence remained constant for most of the decade, except in 2019, when a population-based mailed FIT outreach program was implemented to complement usual visit-based screening. Despite the disruptions caused by the COVID-19 pandemic, screening rates in 2020 did not drop below pre-2019 levels (~40%), though the prior increases due to the mailed FIT program were lost. We believe that effective implementation of broad population-based, screening outreach efforts are instrumental in improving and sustaining CRC SUTD rates in safety-net health systems, and can consequently help to decrease CRC incidence and related mortality.

Strongyloides: a Minireview and Update

Strongyloidiasis, typically caused by Strongyloides stercoralis, is a neglected tropical disease that affects 30 to 100 million people worldwide. Despite the commonly asymptomatic nature of the infection, S. stercoralis infection of immunocompromised individuals can be lethal. Infected but asymptomatic immunocompetent individuals can develop hyperinfection or disseminated infection if they experience any significant change in their immune status, and recently, cases have been described following the use of corticosteroids to treat COVID-19-related pneumonia. Definitive diagnosis is established via stool examination for rhabditiform larvae;however, contemporary methods, including serologic and molecular testing, are increasingly used as adjunct tests. Importantly, exposed individuals and those expected to become immunosuppressed should be screened and pre-emptively treated before starting immunosuppressive agents to avoid cases of dissemination and hyperinfection. Copyright © 2022 Elsevier Inc.

A Rare Presentation of Strongyloides stercoralis Infection from an Immunocompetent Individual in a Tertiary Care Center in South India

Strongyloidiasis is a neglected parasitic disease caused by the intestinal parasite, Strongyloides stercoralis. Most patients with strongyloidiasis are asymptomatic, but few present with varied clinical manifestations such as cutaneous, gastrointestinal, pulmonary, and disseminated disease. It creates a diagnostic dilemma and undue delay in the diagnosis of patients. We report the case of a 79-yearold male who presented with fever and abdominal pain due to strongyloidiasis with no history of immunosuppression. The infection resolved entirely on treatment with ivermectin.