Diagnosis
The following patients should be investigated for strongyloidiasis:
- travelers or people who migrate from an endemic area and develop the following within 3-4 weeks of travel:
- persistent unexplained eosinophilia
- should be investigated further in the first instance by repeating the test to confirm the result
- other common causes (atopy, drugs) should be excluded by obtaining a carful history of the patient
- present during the acute and chronic stages, but may be absent with dissemination (2)
- gastrointestinal symptoms: nausea, vomiting, abdominal pain, bloating
- pulmonary symptoms: fever, wheeze, persistent cough
- cutaneous symptoms: larva currens, hives, or pustules
- persistent unexplained eosinophilia
Further investigations carried out in patients include:
- three stool samples for microscopy - collected on separate days
- although the test has low sensitivity for detecting S stercoralis (around 50%) it is considered to be the gold standard for diagnosis
- larvae usually appear in stools 3-4 weeks after dermal penetration.
- blood test for S stercoralis serology
- detects IgG to a filariform larval antigen
In patients with massive autoinfection the rhabditiform larvae are present in sputum and faeces.
Reference:
Create an account to add page annotations
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.