Background
Imported strongyloidiasis is increasingly being diagnosed in non-endemic areas. The aim of this study was to describe the epidemiological, clinical and microbiological characteristics of patients with imported strongyloidiasis in Spain.
Methodology
This is an observational retrospective study that included all patients diagnosed of strongyloidiasis registered in the +REDIVI Collaborative Network from 2009 to 2017. Demographic, epidemiological and clinical information was collected from the +REDIVI database, and extra information regarding microbiological techniques, treatment and follow-up was requested to participant centers.
Findings
Overall, 1245 cases were included. Most of them were immigrants (66.9%), and South America was the most frequent area of origin. Detection of larvae in stool samples was observed in 21.9% of the patients, and serological tests allowed making the diagnosis in the rest of the cases. Eosinophilia was present in 82.2% of cases. Treatment with ivermectin (compared with albendazole) was the most strongly associated factor to achieve the cure (OR 2.34).
Conclusions
Given the long latency of the infection and the risk of developing a severe presentation, screening of
S
.
stercoralis
infection should be mandatory in patients coming from or had traveling to endemic areas, especially in those with immunosuppressant conditions.
Sexual transmission has replaced intravenous drug use as the most common mechanism of HIV transmission. A large percentage of patients were simultaneously diagnosed with HIV and AIDS, indicating the need for new prevention strategies.
The medical records of 157 patients taking pyrimethamine-sulfadoxine for Pneumocystis carinii pneumonia prophylaxis were reviewed for assessment of safety and tolerance. 11 patients had experienced side effects, 7 (1 each: neutropenia, Stevens-Johnson, hepatic abnormalities; 2 each: subjective and hypersensitivity reactions) leading to a discontinuation of the drugs.
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