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. 2010 Jun;82(6):1088-93.
doi: 10.4269/ajtmh.2010.09-0332.

High rate of strongyloidosis infection, out of endemic area, in patients with eosinophilia and without risk of exogenous reinfections

Silvia A Repetto  1 , Pablo A Durán, María B Lasala, Stella M González-Cappa
Affiliations

High rate of strongyloidosis infection, out of endemic area, in patients with eosinophilia and without risk of exogenous reinfections

Silvia A Repetto et al. Am J Trop Med Hyg. 2010 Jun.

Abstract

Strongyloides stercoralis chronic infections are usually asymptomatic and underestimated. We used direct fresh stool examination, Ritchie's method, and agar plate culture for diagnosis in patients with eosinophilia and previous residence in endemic areas. The frequency of strongyloidosis detected among these patients was high: 21 of 42 were positive. Among them, 10 were positive only by agar plate culture. After ivermectin treatment, patients resulted negative for parasitological tests and reduced their eosinophil counts. Half of the submitted patients that were followed 4-12 months after treatment remained negative without eosinophilia, except one who showed an eosinophil ascending curve before reappearance of larvae in stools. The high frequency of strongyloidosis found in this group emphasizes the relevance of including this parasitosis among differential diagnosis in patients with eosinophilia and past risk of S. stercoralis infection to prevent disseminated infections secondary to corticoid therapy.

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Conflict of interest statement

Disclosure: SMGC is a member of the Research Career from CONICET, and SAR is a fellow of UBA, Argentina.

Figures

Figure 1.
Figure 1.
Detection of Strongyloides stercoralis larvae in stool samples: 1: Fresh stools. 2: Ritchie's method. 3: Agar plate cultures.
Figure 2.
Figure 2.
Follow-up of cultures by microscopical observation of rhabditoid larvae. Period of larvae detection in individual patients. Cultures were considered positive as described in Materials and Methods section. P = patients.
Figure 3.
Figure 3.
Eosinophil count before and after ivermectin treatment. Median eosinophils/mm3 pre- and post-treatment is represented as box and whiskers plot. (P < 0.0001, pre-treatment vs. post-treatment by Wilcoxon signed-rank test).
Figure 4.
Figure 4.
Eosinophil counts in individual patients before and at different times after treatment. Values over the dashed line represent eosinophilia.
See this image and copyright information in PMC

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