Disseminated strongyloidiasis occurs in immunosuppressed patients, can cause abdominal pain, shock, lung and CNS complications and septicaemia, and is potentially fatal.
- Nematode (roundworm) Strongyloides stercoralis
- Infects 30 million people in 70 countries
- Found in soil and penetrates bare feet
- Migrates through vasculature
- Reaches lungs ascends airway and swallowed
- Invades the small intestine and sheds more
- Eggs hatch into the intestinal mucosa
- Repeated endogenous reinfection results in chronic infection
- This can last for several decades
- Often no symptoms.
- GI: diarrhoea, abdominal discomfort, bleeding, weight loss, nausea, and anorexia
- Lung: Loeffler syndrome
- Urticarial rashes in the buttocks and waist areas.
- Larva migrans: These are migratory, serpiginous, urticarial rashes
- FBC/DWCC: Blood eosinophilia is generally present during the acute and chronic stages, but may be absent with dissemination.
- Stool sample: single stool examination by use of conventional techniques fail to detect larvae in up to 70% of cases
- ELISA was 88% sensitive, 99% specific
- Ivermectin is the best drug for the treatment of uncomplicated S. stercoralis infection. Well tolerated and more effective than Albendazole.
- Albendazole 400 mg BD for 3 days which may be repeated after 3 weeks