Leebert Palima

A human parasitic disease caused by

Strongyloides stercoralis, or sometimes
S. fülleborni, which is a type of helminth.
Strongyloides stercoralis
 Female

Male
Contaminated moist soil
 Contact with contaminated soil with the Agent
Strongyloides stercoralis larva.
Infection begins when the filiform larvae
penetrate the skin.
Then migrate through the blood vessels
into the lungs, where they enter alveoli &
travel up the respiratory tree into the
trachea & glottis.
Can cause intestinal infection
The larvae are then swallowed & complete
their life cycle by maturing into adult worms
in the small intestine.
One month after the initial infection, the adult
female worms lay eggs in the intestinal
mucosa. The individual becomes
immunocompromised
The eggs hatch into noninfectious larvae,
which either pass in the feces or mature into
the filiform larvae in the intestines or perianal
skin.
 The time period from exposure of
an individual to the development of
larvae in the feces is approximately 1
month, but the time to appearance of
symptoms may be years.
 Most affected people are asymptomatic
 Pruritic erythematous plaque or migrating linear
urticaria
 Cough and sore throat may develop.
 Cough, wheezing, transient pulmonary infiltrates,
and eosinophilia associated with Loffler’s Syndrome
 Abdominal fullness, pain, and diarrhea alternating
with constipation may occur.
 Weight loss & occasionally occult blood in the stool.
Larva currens
Malabsorption
Protein losing enteropathy,
hypoalbuminemia, generalized edema,
ileus and necrotic bowel.
Diffuse bronchopneumonia,
bronchospasm, intra-alveolar
hemorrhage, cavitation, pleural effusions,
pulmonary abscess, and respiratory
failure.
Pruritic erythematous Larva currens
plaque
 Cough
Migrating Constipation
Strongyloides
larvae

Malabsorption Diarrhea
Sore Throat Nausea Vomiting

Necrotic
Bowel
Lung Abscess
Pulmonary migration
Stool examination
Duodenal aspiration (obtained using
endoscopy)
Culture (using damp charcoal or filter
paper techniques)
ELISA
Inflammatory bowel disease
Tropical pulmonary eosinophilia
(usually has high eosinophil count)
 Sepsis, Bacteremia, Pneumonia
 Peritonitis
 Endocarditis
 neurologic manifestations such as:
oMeningitis
oSeizures
oConfusion
oFocal neurologic signs.
Ivermectin
Thiabendazole (nausea, vomiting, foul
smelling urine, unpleasant taste,
dizziness)
Albendazole
Mebendazole
 Dispose of human feces in sanitary manner.
 Wear shoes in endemic areas.
 Treat infected pets & domestic animals that come in
contact with humans.
 Use caution in starting patients on
immunosuppressive agents if they have chronic GI
symptoms & are from an endemic area.
 Community education
• Monitor for therapeutic effectiveness:
Indicated by negative stool samples.
Monitor for cardiovascular effects of
Ivermectin such as orthostatic hypotension
and tachycardia.
Monitor for and report inflammatory
conditions of the eyes.
Get a follow-up stool examination to
determine effectiveness of treatment.
Treatment for worms does not kill adult
parasites; repeated follow-up and retreatment
are usually needed.
Notify physician if eye discomfort develops.
Do not breast feed while taking Ivermectin
without consulting physician.