Strongyloides stercoralis

(Threadworm)

Audra Spring
 Morphology
It’s a nematode, so it has two larval forms:
Rhabditiform larvae Filariform larvae
(non-infective form) (pathogenic form)
 Morphology
The size and shape of the worm are dependent on
whether it’s parasitic or free-living.

• Free-living females – 1 mm by 60 µm
• Parasitic females – 2.2 mm by 45 µm
• Eggs – 55 µm by 30 µm
 Epidemiology
Found worldwide
– An estimated 50 to 100 million cases
Favors warmer tropical and subtropical climates
Endemic in sub-Saharan Africa, Latin America, southeast
Asia, and the southeastern United States
 Epidemiology
– Worms can be free-living in the soil or live
in a host.
– Only females are parasitic.
– The definitive host is humans, but may
also affect other primates and dogs
 Life Cycle

Dirt Skin Blood

Feces

fec tion
Autoin

Intestine Heart
Lungs
 Strongyloidiasis
– Strongyloides stercoralis has a
direct parasitic life cycle,
meaning it can complete its
entire life cycle in the definitive
host.
– This causes an autoinfection in
the human, because the worm
keeps infecting them without
ever leaving.
– Disseminated strongyloidiasis,
or hyperinfection, occurs in
immunocomprised victims
when the worms spread
throughout the body, leading
to sepsis and secondary
bacterial infections.
– Hyperinfection has an 85%
fatality rate.
Symptoms
– Commonly asymptomatic
– But symptoms may include:
1. Gastrointestinal (diarrhea,
abdominal pain, malabsorption)
2. Respiratory (coughing, wheezing)
3. Dermatologic (ground itch, rash)
4. Anemia
– People with weaker immune systems such as
elderly people and children are more
susceptible.
– Immunosuppressed patients have further
complications (disseminated strongyloidiasis
and hyperinfection).
– Infection is diagnosed primarily by stool
samples, but string tests may also be used
 Treatment
The drug of choice is
thiabendazole, with and
eradication rate of 70-90%.
• Side effects, such as
dizziness, drowsiness, and
gastrointestinal problems
Albendazole and ivermectin are
alternatives, with a 60-90%
eradication rate.
• These have fewer side effects
than thiabendazole.
All antihelminthic drugs that
either kill the worm on contact,
change the permeability of their
membranes, or paralyze them
 Prevention
Properly dispose of
human wastes.

Wear Shoes.

…Don’t eat dirt.

 References
• Sing, Andreas, Lorenz Leitritz, Johannes R. Bogner, and Jürgen Heesemann,. “First-Glance
Diagnosis of Strongyloides stercoralis Autoinfection by Stool Microscopy.” Journal of Clinical
Microbiology. May 1999: p. 1610-1611, Vol. 37, No. 5. 11 October 2006.
<http://jcm.asm.org/cgi/content/full/37/5/1610>

• Lehman, Don. “Strongyloides stercoralis.” Diagnostic Parasitology. 1999. University of Delaware.

1 October 2006. <http://www.udel.edu/medtech/dlehman/medt372/S-strong.html>

• “Taxonomy, Common Name, Disease.” Strongyloides stercoralis. College of Agricultural and

Environmental Sciences. 1 October 2006.
<http://ucdnema.ucdavis.edu/imagemap/nemmap/ENT156HTML/nemas/strongyloidessterc
oralis>

• “2-Nematodes: Hookworms (Ancylostoma duodenale, Necator americanus) & Strongyloides

stercoralis.” Columbia University. 1 October 2006.
<http://64.233.161.104/search?q=cache:e3OfkQy-
GEIJ:healthsciences.columbia.edu/dept/ps/2007/para/old/PD2_lczanko.pdf+morphology+stro
ngyloides+stercoralis&hl=en&gl=us&ct=clnk&cd=3>

• Zepf, Bill. “Strongyloides stercoralis Infection Can Be Fatal.” American Family Physician. 15
March 2002. FindArticles.com. 1 October 2006.
<http://findarticles.com/p/articles/mi_m3225/is_6_65/ai_84072809>

• “Strongyloidiasis.” Library Identification of Parasites of Public Health Concern. 26 September

2005. Centers of Disease Control. 1 October 2006.
<http://www.dpd.cdc.gov/dpdx/HTML/Frames/S-
Z/Strongyloidiasis/body_Strongyloidiasis_page1.htm>