A series on intestinal strongyloidiasis in immunocompetent and immunocompromised hosts.
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Date
2012-04
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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.
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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.