Strongyloidiasis overview: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
It is thought to affect 30–100 million people worldwide, mainly in tropical and subtropical countries. Worldwide efforts are aimed at eradicating the infection in high-risk groups. | It is thought to affect 30–100 million people worldwide, mainly in tropical and subtropical countries. Worldwide efforts are aimed at eradicating the infection in high-risk groups. | ||
==Diagnosis== | |||
===History and Symptoms=== | |||
Strongyloides infection occurs in five forms. On acquiring the infection, there may be respiratory symptoms ([[Löffler's syndrome]]). The infection may then become chronic with mainly digestive symptoms. On reinfection (when larvae migrate through the body), there may be respiratory, skin and digestive symptoms. Finally, the hyperinfection syndrome causes symptoms in many organ systems, including the [[central nervous system]].<ref name=Montes>{{cite journal | author=Montes M, Sawhney C, Barros N | title=Strongyloides stercoralis: there but not seen | journal=Curr Opin Infect Dis | year=2010 | month=Oct | volume=23 | issue=5 | pages=500–4 | pmid=20733481 | pmc=2948977 | doi=10.1097/QCO.0b013e32833df718}}</ref><ref name=Marcos>{{cite journal | author=Marcos LA, Terashima A, Dupont HL, Gotuzzo E | title=Strongyloides hyperinfection syndrome: an emerging global infectious disease | journal=Trans R Soc Trop Med Hyg | year=2008 | month=Apr | volume=102 | issue=4 | pages=314–8 | pmid=18321548 | doi=10.1016/j.trstmh.2008.01.020}}</ref> | |||
==Treatment== | ==Treatment== | ||
Revision as of 16:40, 11 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Strongyloidiasis is a human parasitic disease caused by the nematode (roundworm) Strongyloides stercoralis, or sometimes S. fülleborni. It can cause a number of symptoms in people, principally skin symptoms, abdominal pain, diarrhea and weight loss. In some people, particularly those who require corticosteroids or other immunosuppressive medication, Strongyloides can cause a hyperinfection syndrome that can lead to death if untreated. The diagnosis is made by blood and stool tests. The drug ivermectin is widely used in the treatment of strongyloidiasis.
Historical Perspective
Strongyloidiasis was first described in France in 1876.
Pathophysiology
The nematode (roundworm) Strongyloides stercoralis. Other Strongyloides include S. fülleborni, which infects chimpanzees and baboons and may produce limited infections in humans.The Strongyloides life cycle is more complex than that of most nematodes with its alternation between free-living and parasitic cycles, and its potential for autoinfection and multiplication within the host. Two types of cycles exist.
Epidemiology and Demographics
It is thought to affect 30–100 million people worldwide, mainly in tropical and subtropical countries. Worldwide efforts are aimed at eradicating the infection in high-risk groups.
Diagnosis
History and Symptoms
Strongyloides infection occurs in five forms. On acquiring the infection, there may be respiratory symptoms (Löffler's syndrome). The infection may then become chronic with mainly digestive symptoms. On reinfection (when larvae migrate through the body), there may be respiratory, skin and digestive symptoms. Finally, the hyperinfection syndrome causes symptoms in many organ systems, including the central nervous system.[1][2]
Treatment
Medical Therapy
The drug of choice for the treatment of uncomplicated strongyloidiasis is ivermectin with albendazole as the alternative. All patients who are at risk of disseminated strongyloidiasis should be treated. (Albendazole is approved by the FDA, but considered investigational for this purpose).[3]
Prevention
Good personal hygiene can reduce the risk of strongyloidiasis. Public health services and sanitary facilities provide good infection control.
References
- ↑ Montes M, Sawhney C, Barros N (2010). "Strongyloides stercoralis: there but not seen". Curr Opin Infect Dis. 23 (5): 500–4. doi:10.1097/QCO.0b013e32833df718. PMC 2948977. PMID 20733481. Unknown parameter
|month=ignored (help) - ↑ Marcos LA, Terashima A, Dupont HL, Gotuzzo E (2008). "Strongyloides hyperinfection syndrome: an emerging global infectious disease". Trans R Soc Trop Med Hyg. 102 (4): 314–8. doi:10.1016/j.trstmh.2008.01.020. PMID 18321548. Unknown parameter
|month=ignored (help) - ↑ http://www.dpd.cdc.gov/dpdx/HTML/Strongyloidiasis.htm