[An overview of Strongyloides stercoralis and its infections]

Nurittin Ardiç
Mikrobiyoloji Bülteni 2009, 43 (1): 169-77
Strongyloidiasis which is an infection caused by Strongyloides stercoralis, has a cosmopolitan distribution in tropical and subtropical regions; whereas, it is sporadic in Turkey. It is estimated that 30-100 million people are infected with this agent worldwide. The infection is usually asymptomatic, however, eosinophilia may be the only sign. S. stercoralis have the ability to persist and replicate within the host for decades and it may lead to infections with high mortality especially in immunocompromised host. Humans are generally infected transcutaneously with filariform larvae. Infections with S. stercoralis usually lead to cutaneous, gastrointestinal, or pulmonary symptoms. Definitive diagnosis of strongyloidiasis is made on the basis of detection of larvae in the stool, sputum or duodenal fluid. Hovewer, strongyloidiasis is difficult to diagnose since the parasite load is low and the larval output is irregular in majority of the patients. This situation necessitates the collection of consecutive samples and the use of concentration techniques. The burden of Strongyloides may be overlooked in especially non-endemic regions. Strongyloidiasis should be considered before the application of immunosuppressive therapy in patients with unexplained eosinophilia, serpiginous skin lesions, or pulmonary or gastrointestinal symptoms. The goal of treatment is to eliminate the parasites and ivermectin is the drug of choice. Besides, albendazole or thiabendazole may used as alternative agents in the treatment. Improved human waste disposal services are considered to be the main requirement to reduce the high prevalence of this disease. In this review, it was aimed to withdraw attention to strongyloidiasis and to overview its prevalence, clinical manifestations, diagnosis, management and prevention strategies.

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