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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Most infections are either mild or asymptomatic. In these patients an increase in peripheral blood eosinophil count is the only sign of infection (1).

skin manifestations

  • ground itch
    • characteristic cutaneous reaction following acute larvae invasion of the skin
    • most commonly affects the foot
    • may cause serpiginous or urticarial tracts with severe pruritus lasting for several days

Note: this should be differentiated form from cutaneous larva migrans

  • larva currens (literally “running larvae”)
  • intensely itchy red tracts seen in the perianal area and upper thighs due to rapid speed of intradermal migration (progressing at around 5-15 cm per hour) of the parasite in chronic infection
  • pathognomonic for strongyloidiasis

pulmonary manifestations

  • dry cough or wheeze
  • Loeffler’s-like syndrome
    • rare
    • characterised by fever, dyspnoea, wheeze, pulmonary infiltrates on chest radiographs, and accompanying blood eosinophilia

gastrointestinal manifestations

  • diarrhoea, anorexia, and vomiting
  • epigastric pain worsened by eating (2)

Disseminated strongyloidiasis seen in immunosuppressed patients may present with

  • abdominal pain and distension
  • shock
  • pulmonary and neurologic complications
  • septicemia (2)

Reference:


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