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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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