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Strongyloidiasis

Various health complications can result if left untreated if Strongyloidiasis, a parasitic infection caused by the nematode (roundworm) Strongyloides stercoralis, persists in tropical and subtropical regions. Understanding the causes, recognizing symptoms, diagnosing accurately, and implementing effective treatment and prevention strategies are critical for managing this condition.

Causes

Generally, Strongyloidiasis occurs when the larvae of the parasitic worm Strongyloides stercoralis penetrate the skin through contact with contaminated soil. Once inside the body, the larvae migrate to the lungs and then to the intestines, where they mature into adult worms and reproduce. As larvae can reenter the bloodstream and migrate to other organs, systemic infections can also occur.

Symptoms

The symptoms of strongyloidiasis vary depending on the severity of the infection and the individual's immune response. Common symptoms include:

  • Pain in the abdomen

  • Constipation or diarrhea

  • Vomiting and nausea

  • Appetite loss

  • Loss of weight

  • Tiredness

  • Itching or rash on the skin

  • If larvae migrate to the lungs, coughing and shortness of breath may occur.

Strongyloidiasis can lead to life-threatening complications, such as hyperinfection syndrome or disseminated disease, which can involve multiple organs in severe cases.

Diagnosis

In order to diagnose strongyloidiasis, healthcare providers consider the patient's symptoms, travel history, and potential exposure to contaminated soil. Laboratory tests commonly used include:

  • The presence of Strongyloides larvae can be detected by microscopic examination of stool samples.

  • Blood tests may detect antibodies produced by the body in response to Strongyloides infection, although these tests are not always reliable, especially in individuals with compromised immune systems.

  • A procedure called duodenal aspiration may be performed to collect fluid from the small intestine for examination under a microscope in some cases.

Treatment

The most common medication used for the treatment of strongyloidiasis is to kill the parasitic worms. These medications include:

  • Infections caused by Strongyloides stercoralis can be effectively treated with ivermectin, an antiparasitic medication.

  • Another antiparasitic medication that may be used as an alternative treatment if ivermectin is unavailable or contraindicated is albendazole.

Hyperinfection syndrome or disseminated disease may require hospitalization and additional supportive measures, such as corticosteroids to reduce inflammation and antibiotics to prevent secondary bacterial infections.

Prevention

Strongyloidiasis can be prevented by avoiding soil contamination and taking precautions when traveling to endemic areas. Prevention strategies include:

  • Avoid walking barefoot, especially in areas where the parasite is prevalent.

  • Before eating or handling soil, wash your hands thoroughly with soap and water.

  • Drink only clean, safe water and avoid swimming or bathing in contaminated waters.

  • Prompt diagnosis and treatment of infected individuals can help prevent the spread of the parasite.

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