[The importance of Strongyloides stercoralis revisited]

Abstract

Strongyloidiasis is a worldwide parasitic disease and of great importance in Brasil. Among the diverse species of Strongyloides, only the following are of importance to man: S. stercoralis, S. fulleborni and S. fullerboni-like. Eventhough S. stercoralis is an intestinal helminth, strongyloidiasis is a systemic infection that can affect, beside the gastrointestinal tract, lungs, CNS, liver and biliary tract, pancreas, genitourinary tract and skin. The great majority of cases are asymptomatic, having a chronic and benign course. Among the symptomatic subjects, the gastrointestinal and pulmonary symptoms prevail. For unknown reasons, strongyloides infection may result in severe, disseminated disease. Immunosuppressive, therapy was identified as an important risk factor for disseminated illness. Diagnosing strongyloidiasis may be difficult, and eventhough the parasitological stool examination is the most used diagnostic test, sometimes larvae cannot be identified. Immunodiagnosis is not yet assessible for routine usage and is still a subject of research. Thiabendazole remains the drug of choice for treatment of strongyloidiasis, but other drugs, such as ivermectin, have been used. The purpose of this paper was to review the important aspects of the S. stercoralis infection in man.