infectious diseases
Strongyloidiasis
Symptoms and Signs of Strongyloidiasis
Acute and chronic strongyloidiasis can be asymptomatic. Withacute strongyloidiasis,the initial manifestation can be a pruritic, erythematous rash at the site where larvae entered the skin. A cough may develop as larvae migrate through the lungs and trachea. Larvae and adult worms in the gastrointestinal tract can cause abdominal pain, diarrhea, and anorexia. can persist for years due to autoinfection. It may be asymptomatic or characterized by gastrointestinal, pulmonary, and/or cutaneous symptoms. Gastrointestinal complaints include abdominal pain and intermittent diarrhea and constipation. Tests for occult blood in stool may be positive, and on rare occasion, frank gastrointestinal hemorrhage can occur. The symptoms can mimic the Symptoms and Signs , those of other causes of Larva currens(creeping infection) is a form of cutaneous larva migrans specific toStrongyloidesinfection; it results from autoinfection. The eruption usually begins in the perianal region and is accompanied by intense pruritus. Typically, larva currens is a linear or serpiginous, rapidly migrating (up to 10 cm/hour), erythematous, urticarial skin lesion. Nonspecific maculopapular or urticarial eruptions may also occur. Pulmonary symptoms are uncommon, although heavy infections may cause Löffler Syndrome , with cough, wheezing, and Gastrointestinal and pulmonary symptoms are often prominent. Bacteremia may develop when the larvae invade the bowel disrupting the mucosa and carrying bacteria on their surface. Ileus, obstruction, massive gastrointestinal bleeding, severe malabsorption, and peritonitis may occur. Pulmonary symptoms include dyspnea, hemoptysis, and respiratory failure. Infiltrates may be seen on chest x-ray or CT scan. Other symptoms depend on the organs involved. Central nervous system (CNS) involvement includes parasitic meningitis, brain abscess, and diffuse invasion of the brain. Secondary gram-negative meningitis and bacteremia, which occurs with high frequency, probably reflect disruption of bowel mucosa, carriage of bacteria on migrating larvae, or both. Liver infection may result in cholestatic and granulomatous hepatitis. Hyperinfection and disseminated strongyloidiasis are often fatal in immunocompromised patients, even with treatment. 