Infectious Disease Book

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Strongyloides

Aka: Strongyloides, Strongyloides stercoralis, Strongyloidiasis
  1. Classification
    1. Nematode: Roundworm
  2. Epidemiology
    1. Responsible for most U.S. cases fatal Helminth disease
    2. Endemic areas
      1. Tropical Asia
      2. Sub-Saharan Africa
      3. Latin America
      4. Pockets in Rural southeastern United States
      5. Pockets in Eastern Europe
  3. Pathophysiology
    1. Adult roundworms live in the Small Intestine
    2. Larvae infect perianal skin
  4. Risk Factors: Hyperinfection (Immunocompromised)
    1. Chronic Corticosteroid use
    2. Chemotherapy
    3. Human Immunodeficiency Virus (HIV)
  5. Differential Diagnosis
    1. Peptic Ulcer Disease
  6. Symptoms
    1. Often asymptomatic in immunocompetent patients
    2. Larva currens
      1. Recurrent serpiginous Urticaria
      2. Onset in perianal area
      3. Migratory rash to buttocks, groin, trunk
    3. Gastrointestinal side effects
      1. Abdominal Pain or abdominal bloating
      2. Diarrhea
    4. Pulmonary involvement
      1. Cough
      2. Shortness of Breath
      3. Dyspnea
      4. Hemoptysis
  7. Labs
    1. Eosinophilia (blood or stool)
      1. May be only finding in immunocompetent patients
    2. Guaiac-positive stools
    3. Rhabditiform larvae present in sample
      1. Stool sample or duodenal aspiration
      2. False negative test: 70% of cases
  8. Management
    1. Ivermectin (now preferred agent)
      1. Dose: 200 mcg/kg orally daily for 2 days
      2. Repeat every 15 days for disseminated infection until stool testing negative (and then one more treatment)
      3. Continuous dosing daily for hyperinfection (e.g. Sepsis, Meningitis) continued until stool and Sputum negative for 2 weeks
    2. Other agents
      1. Albendazole 400 mg orally twice daily for 7 days (for asymptomatic of intestinal infection)
      2. Thiabendazole (not available, poorly tolerated, less effective)
  9. Complications: Hyperinfection
    1. Meningitis
    2. Septic Shock
  10. Prognosis
    1. Hyperinfection mortality rate in immunosuppressed: 87%
  11. References
    1. Gilbert (2016) Sanford Guide, IOS version, accessed 9/12/2016
    2. Siddiqui (2001) Clin Infect Dis 33:1040-7 [PubMed]

Strongyloides (C0038461)

Definition (MSH) A genus of parasitic nematodes widely distributed as intestinal parasites of mammals.
Concepts Eukaryote (T204)
MSH D013321
SnomedCT 10823008
English Strongyloides, Strongyloide, strongyloides, Genus: Strongyloides, Strongyloides (organism), Strongyloides, NOS
Swedish Strongyloides
Czech Strongyloides
Finnish Strongyloides
French Anguillules, Strongyloides
Polish Węgorki
Norwegian Strongyloides
Spanish Strongyloides (organismo), género: Strongyloides, Strongyloides
German Strongyloides
Italian Strongili
Russian STRONGYLOIDES
Dutch Strongyloides
Portuguese Strongyloides
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Strongyloides stercoralis (C0038462)

Definition (MSH) A species of parasitic nematode widely distributed in tropical and subtropical countries. The females and their larvae inhabit the mucosa of the intestinal tract, where they cause ulceration and diarrhea.
Concepts Eukaryote (T204)
MSH D017171
SnomedCT 42625000
Swedish Strongyloides stercoralis
Czech Strongyloides stercoralis, háďátko střevní
Finnish Strongyloides stercoralis
English Strongyloides stercorali, stercoralis, Strongyloides, stercorali, Strongyloides, Strongyloides intestinalis, Strongyloides stercoralis (organism), Strongyloides stercoralis
Polish Węgorek jelitowy
Norwegian Strongyloides stercoralis, Trådorm
Spanish Strongyloides stercoralis (organismo), Strongyloides stercoralis
French Strongyloides stercoralis
German Strongyloides stercoralis
Italian Strongyloides stercoralis
Russian STRONGYLOIDES STRECORALIS
Dutch Strongyloides stercoralis
Portuguese Strongyloides stercoralis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Strongyloidiasis (C0038463)

Definition (MSH) Infection with nematodes of the genus STRONGYLOIDES. The presence of larvae may produce pneumonitis and the presence of adult worms in the intestine could lead to moderate to severe diarrhea.
Definition (CSP) infections with nematodes of the order Strongylida; includes Oesophagostomiasis, hook worm infection, trichostrongyloidiasis and equine strongylosis.
Concepts Disease or Syndrome (T047)
MSH D013322
ICD9 127.2
ICD10 B78, B78.9
SnomedCT 187177001, 187537002, 1214006
English Strongyloidiases, Strongyloidiasis, Strongyloidiasis, unspecified, Strongyloidiasis,unspecifd, [X]Strongyloidiasis, unspecified, [X]Strongyloidiasis,unspecifd, strongyloidiasis (diagnosis), strongyloidiasis, Strongylodiasis, Strongyloidiasis [Disease/Finding], strongylodiasis, strongyloidosis, strongyloides infection, [X]Strongyloidiasis, unspecified (disorder), Strongyloidosis, Infection by Strongyloides (disorder), Infection by Strongyloides, anguillulosis, Infection by Strongyloides, NOS
Italian Strongiloidiasi, Strongiloidosi
French Strongyloïdiose, Strongyloïdose
German Strongylodiasis, Strongyloidiasis, nicht naeher bezeichnet, Strongyloidiasis
Japanese 糞線虫症, フンセンチュウショウ
Swedish Strongyloidiasis
Czech strongyloidiáza, Strongyloidóza
Finnish Strongyloidiaasi
Russian ANGUILLULA INTESTINALIS INVAZIIA, STRONGILOIDOZ, ANGUILLULA INTESTINALIS ИНВАЗИЯ, СТРОНГИЛОИДОЗ
Korean 상세불명의 분선충증, 분선충증
Croatian STRONGILOIDIJAZA
Polish Zarażenie węgorkiem jelitowym, Węgorczyca, Strongyloidoza
Hungarian Strongyloidiasis, Strongylodiasis
Spanish [X]estrongiloidiasis, no especificada, [X]Strongyloidiasis, unspecified (disorder), [X]estrongiloidiasis, no especificada (trastorno), [X]Strongyloidiasis, unspecified, estrongiloidiasis, estrongiloidiosis, infección por Strongyloides (trastorno), infección por Strongyloides, Estrongiloidiasis
Dutch Strongyloidiasis, niet gespecificeerd, strongyloidiasis, Strongyloidiasis
Portuguese Estrongiloidíase
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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