Strongyloidiasis (Worm Infection)

Strongyloidiasis is primarily an infection of the intestinal system caused most commonly by the worm Strongyloidiasis stercoralis and to a lesser extent Strongyloidiasis fulleborni. The symptoms are of larval migration across the skin leading to intense itching; cough as the larvae enter the lung and abdominal pain and diarrhea with intestinal infection.

Where does it occur?

Strongyloides stercoralis infection occurs primarily in tropical and temperate areas the world over. S. fulleborni is seen only in Africa and Papua New Guinea.

How is it transmitted?

The infectious larvae reside in soil and penetrate the skin, enter the blood circulation, migrate to the lungs and trachea, and then once coughed up are swallowed into the digestive tract.

Is it contagious from person to person?

It is not contagious from person to person.

What is the risk for travelers?

The risk is generally low, unless walking barefoot in tropical and temperate areas.

How soon after exposure will one develop symptoms?

How soon symptoms develop varies widely and is not fully known.

What are the signs and symptoms?

Initial symptom as the larvae penetrate the skin is an itchy rash. As the larvae enters the lung one can see fever, cough and some shortness of breath. As the larvae reaches the small intestine and matures into adult worm one can experience abdominal pain, nausea, and diarrhea and generalized itching.

The adult worms release larvae and these can sometimes infect the individual all over again as it penetrates the skin of the anus and gains entry in the blood stream resulting in what is called hyperinfection with large numbers of worms. These can result in overwhelming pneumonia, sepsis with bacterial infection as the intestinal layers are penetrated.

Are there any lab tests to diagnose the illness?

Larvae can be seen in stool, gastric secretions or sputum.

Is there any treatment?

Ivermectin is the drug of choice to treat this infection. Thiabendazole or albendazole are available but less effective.

What preventive measures can be taken?

Wearing footwear in tropical and temperate climates will prevent attaining the infection.

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