Imported strongyloidiasis in Spain

Germán Ramírez-Olivencia, Miguel Ángel Cuesta Espinosa, Ana Bravo Martín, Nuria Iglesias Núñez, Esperanza Rodríguez de Las Parras, Mar Lago Núñez, Sabino Puente Puente
International Journal of Infectious Diseases: IJID 2014, 18: 32-7

OBJECTIVES: The objective of this study was to assess the epidemiological, laboratory, and clinical features of imported strongyloidiasis in a tropical medicine referral unit in Madrid, Spain.

METHODS: This was a retrospective study based on a review of medical records. A patient was diagnosed with strongyloidiasis when the infection could be detected by conventional stool analysis and/or serology against Strongyloides stercoralis, regardless of the presence of symptoms.

RESULTS: One hundred and seventy-eight cases of strongyloidiasis were included in the study. Stool tests were performed in all patients, and serology in 160 patients (89.9%). The diagnosis of strongyloidiasis was based on serology only in four patients; 21 patients only had positive stool tests. A third of the total strongyloidiasis cases in this study were travel-related, mainly associated with short trips (<2 months). Only 47.8% of total cases were symptomatic. We found no differences in clinical presentation between immigrants and travelers with strongyloidiasis.

CONCLUSIONS: Not only should strongyloidiasis be suspected in symptomatic travelers and immigrants, but it should also be ruled out when elevated IgE levels or eosinophilia are present. Strongyloidiasis can be asymptomatic in HIV patients, but it should be diagnosed and treated before a possible hyperinfection develops.

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