Strongyloides stercoralis, the hidden worm. Epidemiological and clinical characteristics of 70 cases diagnosed in the North Metropolitan Area of Barcelona, Spain, 2003–2012

Abstract

During the study period, 90% of the cases of Strongyloides stercoralis diagnosed could be considered as imported by immigrants, most being asymptomatic and with eosinophilia. The infection is probably largely underestimated and population-based studies are needed to determine its true prevalence. Meanwhile, diagnosis must be based on active investigation of the helminth (serology and feces culture), especially in immunocompromised patients. The implementation of pre-immunosuppression protocols with the aim of identifying Strongyloides stercoralis is encouraged with empirical treatment with ivermectin being recommended in sites without diagnostic facilities.

Usefulness of Strongyloides stercoralis Serology in the Management of Patients with Eosinophilia

“…However, the index of under-diagnosis is expected to be high, because most patients are asymptomatic. 3,11 Detection of S. stercoralis larvae is the gold standard test for the diagnosis of strongyloidiasis; however, it is not sensitive enough. In chronic infected patients there is high variability caused by the irregular and low output of the larvae in feces.…”

Strongyloides stercoralis infection increases the likelihood to detect Trypanosoma cruzi DNA in peripheral blood in Chagas disease patients

“…While more attention is given to other soil‐transmitted helminths (such as Ascaris lumbricoides , hookworms and Trichuris trichiura ), strongyloidiasis is becoming an emerging global infection, which is underestimated in many countries . Due to the increase in migration and international travel during the last decades, strongyloidiasis is being increasingly diagnosed out of endemic areas, becoming a worldwide disease .…”

Acute Respiratory Distress Syndrome due to Strongyloides stercoralis Infection in a Patient with Cervical Cancer

“…A recent report described the detection of eosinophilia in 90% of patients with S. stercoralis infection, although eosinophilia is often absent in patients with an immunosuppressive status (4,5). The lack of eosinophilia is considered to be one encumbrance delaying a correct diagnosis in this case.…”