A series on intestinal strongyloidiasis in immunocompetent and immunocompromised hosts.

Abstract
Background: Strongyloidiasis, endemic in tropical areas, may be asymptomatic in immunocompetent subjects or may cause potentially fatal hyper-infection in immunocompromised patients. Methods: Of the 13,885 patients referred to the parasitology laboratory at our tertiary care referral center for stool microscopy, 15 were diagnosed as strongyloidiasis over a 6 year period. We assessed these patients retrospectively. Results: Most patients were young (median age 32 years, range 3-66) males (12, 80%). Seven patients (46.6%) were immunocompromised. All patients were symptomatic, and symptoms included chronic diarrhea (4, 26.7%), acute diarrhea (1, 6.7%), abdominal pain (6, 40%), weight loss (3, 20%), cough (2, 13.33%), vomiting (1, 6.7%), anemia (10, 66.7%) and eosinophilia (3, 20%). Thirteen patients (86.6%) were diagnosed on first stool microscopy. Duodenal biopsy showed normal histology in twelve (80%) and partial villous atrophy in one (6.7%) patient. Stool microscopy also revealed giardiasis and cryptosporidiosis in one patient each. Nine patients responded well to ivermectin and albendazole, one died and five were lost to followup. Conclusions: In endemic areas, even immunocompetent subjects may suffer from symptomatic strongyloidiasis and associated eosinophilia is uncommon.
Description
Keywords
chronic diarrhea, villous atrophy, parasite, eosinophilia
Citation
Ghoshal Ujjala, Khanduja Sonali, Chaudhury Nabamita, Gangwar Dinesh, Ghoshal Uday C. A series on intestinal strongyloidiasis in immunocompetent and immunocompromised hosts. Tropical Gastroenterology. 2012 Apr-June; 33(2): 135-139.