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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 3. Summaries of Infectious Diseases
Strongyloidiasis
(Strongyloides stercoralis)Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Asymptomatic infection accompanied by peripheral blood eosinophilia may be the only manifestation of infection. Hence, strongyloidiasis warrants consideration whenever eosinophilia (blood eosinophil concentration >500/µL) without an obvious cause occurs in a patient who has resided in an endemic area. Infective larvae entering the body produce transient pruritic papules at the site of penetration of the skin, usually on the feet. Larval migration through lungs can cause pneumonitis with a cough productive of blood-streaked sputum. The intestinal phase of infection can be accompanied by vague abdominal pain, distention, vomiting, and diarrhea that may be mucoid and voluminous. Malabsorption has been reported. Larval migration from defecated stool can result in pruritic skin lesions in the perianal area, buttocks, and upper thighs. Lesions may present as migrating, pruritic, serpiginous, erythematous tracks called larva currens. In immunocompromised patients, particularly patients receiving corticosteroids, and less commonly in people who are malnourished, alcoholic, or infected with human T-lymphotropic virus type I, complications include disseminated strongyloidiasis (caused by hyperinfection), diffuse pulmonary infiltrates, and septicemia or meningitis from enteric gram-negative bacilli.
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ETIOLOGY: Strongyloides stercoralis is a nematode (roundworm).
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EPIDEMIOLOGY: Strongyloidiasis is endemic in the tropics and subtropics, including the southern
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Related Article
Red Book 2003 2003: 744-770.