ABSTRACT
BACKGROUND: Strongyloidiasis is a parasitic disease with global prevalence. In Spain, autochthonous cases are concentrated in the Mediterranean basin. We aimed to analyze clinical and epidemiological characteristics of Strongyloides stercoralis infection in Vega Baja del Segura (Spain), comparing autochthonous versus imported cases. METHODS: Observational retrospective study of all strongyloidiasis cases from January 2009 to January 2019. Cases were diagnosed by stool larvae visualization, positive culture, PCR, Strongyloides serology, and/or compatible histology. RESULTS: We included 36 patients (21 men) with a mean age of 60.8 years ±17.6; 15 cases were autochthonous and 21 imported 80.9% from Latin America. Autochthonous cases were associated with older age (mean 71.3 vs. 53.3 years; p = 0.002), male sex (odds ratio (OR) 5.33; 95% confidence interval (CI) 1.15-24.68; p = 0.041), and agricultural activity (OR 13.5; 95% CI 2.4-73.7; p = 0.002). Fourteen were asymptomatic, three autochthonous cases presented with hyperinfection syndrome, and two patients died. There was no difference between autochthonous versus imported origin in eosinophilia at diagnosis (93.3% vs. 75%; p = 0.207), treatment received, or clinical response (85.7% vs. 88.9% cured; p = 1). CONCLUSION: In our region, imported strongyloidiasis coexists with autochthonous cases, which are mainly in older male farmers who are diagnosed at more advanced stages. Systematic screening programs are needed.
ABSTRACT
Introducción: La infestación por Strongyloides stercoralis es más prevalente en regiones tropicales, pero existen casos autóctonos en España, principalmente en La Safor (Valencia). Nuestro objetivo era estudiar los casos de un hospital de la provincia de Alicante y conocer si existían casos autóctonos. Procedimiento: Estudio retrospectivo de los casos diagnosticados de estrongiloidiasis en el Hospital Vega Baja (Orihuela, Alicante) entre enero de 1999 y marzo de 2016. Resultados: Se registraron 10 casos, 4 de ellos autóctonos, presentando 2 de ellos un cuadro de hiperinfestación con desenlace fatal. Todos los casos autóctonos fueron en personas ≥69años con síntomas digestivos, cutáneos y/o respiratorios. La serología fue positiva en los 8casos en los que se realizó. En 3 casos se visualizaron larvas en el estudio histopatológico. Conclusiones: Comunicamos los primeros casos autóctonos de estrongiloidiasis en la región Vega Baja. Se deben implantar programas de cribado principalmente en pacientes inmunosuprimidos o en tratamiento corticoideo (AU)
Introduction: Strongyloides stercoralis infection is more prevalent in tropical regions but autochthonous cases have been reported in Spain, mainly in La Safor (Valencia). The objective is to describe the strongyloidiasis cases registered in a regional hospital of Alicante province (Spain) and to determine if they were autochthonous cases. Methods: Retrospective study of all diagnosed cases of strongyloidiasis in Vega Baja Hospital (Orihuela, Alicante) between January 1999 and March 2016. Results: A total of 10 cases were found, four of which were autochthonous cases. Two of them presented with a hyper-infection syndrome, with a fatal outcome. All autochthonous cases were in patients ≥69years old with gastrointestinal, cutaneous, and/or respiratory symptoms. Serology was positive in the 8 cases studied. Larvae were found in histopathological samples of the gastrointestinal tract of three patients. Conclusions: We communicate the first autochthonous cases of strongyloidiasis in the region of Vega Baja. Screening programs should be implemented, especially in immunosuppressed patients or patients under chronic corticosteroid treatment (AU)
Subject(s)
Humans , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/diagnosis , Strongyloidiasis/microbiology , Biopsy , Risk Factors , Immunosuppression Therapy/methods , Strongyloides stercoralis/microbiology , Strongyloidiasis/pathology , Mass Screening/methods , Retrospective Studies , Enzyme-Linked Immunosorbent Assay/methods , Feces/microbiology , Feces/parasitology , Eosinophilia/microbiology , Colon/pathologyABSTRACT
INTRODUCTION: Strongyloides stercoralis infection is more prevalent in tropical regions but autochthonous cases have been reported in Spain, mainly in La Safor (Valencia). The objective is to describe the strongyloidiasis cases registered in a regional hospital of Alicante province (Spain) and to determine if they were autochthonous cases. METHODS: Retrospective study of all diagnosed cases of strongyloidiasis in Vega Baja Hospital (Orihuela, Alicante) between January 1999 and March 2016. RESULTS: A total of 10 cases were found, four of which were autochthonous cases. Two of them presented with a hyper-infection syndrome, with a fatal outcome. All autochthonous cases were in patients ≥69years old with gastrointestinal, cutaneous, and/or respiratory symptoms. Serology was positive in the 8 cases studied. Larvae were found in histopathological samples of the gastrointestinal tract of three patients. CONCLUSIONS: We communicate the first autochthonous cases of strongyloidiasis in the region of Vega Baja. Screening programs should be implemented, especially in immunosuppressed patients or patients under chronic corticosteroid treatment.
Subject(s)
Communicable Diseases, Imported/epidemiology , Strongyloides stercoralis , Strongyloidiasis/epidemiology , Aged , Animals , Female , Hospitals , Humans , Male , Retrospective Studies , Spain/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Echocardiography, Stress/methods , Coronary Disease , Carotid Intima-Media Thickness , Myocardial Ischemia/diagnosis , Risk FactorsSubject(s)
Carotid Intima-Media Thickness , Coronary Artery Disease/diagnosis , Echocardiography, Stress/methods , Aged , Female , Humans , Male , Middle AgedSubject(s)
Humans , Female , Middle Aged , Staphylococcal Infections/complications , Prevotella intermedia/isolation & purification , Noma/diagnosis , Facial Dermatoses/diagnosis , Bacteroidaceae Infections/complications , Bacteroides Infections/complications , AIDS-Related Opportunistic Infections/complications , Plastic Surgery Procedures , Staphylococcal Infections/drug therapy , Substance Abuse, Intravenous/complications , Tomography, X-Ray Computed , Osteolysis , Osteolysis/surgery , Noma/etiology , Noma/surgery , Maxillary Diseases/etiology , Maxillary Diseases/surgery , Hepatitis C, Chronic/complications , Gingivitis/complications , Facial Dermatoses/microbiology , Facial Dermatoses/surgery , Cheek , Combined Modality Therapy , Bacteroidaceae Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , AIDS-Related Opportunistic Infections/drug therapySubject(s)
AIDS-Related Opportunistic Infections/complications , Bacteroidaceae Infections/complications , Bacteroides Infections/complications , Facial Dermatoses/diagnosis , Noma/diagnosis , Prevotella intermedia/isolation & purification , Staphylococcal Infections/complications , AIDS-Related Opportunistic Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Bacteroidaceae Infections/drug therapy , Bacteroides Infections/drug therapy , Cheek , Combined Modality Therapy , Facial Dermatoses/etiology , Facial Dermatoses/microbiology , Facial Dermatoses/surgery , Female , Gingivitis/complications , Gingivitis/microbiology , Hepatitis C, Chronic/complications , Humans , Maxillary Diseases/diagnostic imaging , Maxillary Diseases/etiology , Maxillary Diseases/surgery , Middle Aged , Noma/etiology , Noma/microbiology , Noma/surgery , Osteolysis/diagnostic imaging , Osteolysis/etiology , Osteolysis/surgery , Plastic Surgery Procedures , Staphylococcal Infections/drug therapy , Substance Abuse, Intravenous/complications , Tomography, X-Ray ComputedABSTRACT
No disponible
