17th June 2024

Other nematode infections

Strongyloidiasis

Strongyloides stercoralis is a nematode parasite of the small intestine. Although more common in warmer climates, it has a worldwide distribution. Infection is caused by penetration of the larvae through open skin. They then migrate via the bloodstream and lymphatics to the lungs before subsequently being coughed up and swallowed. The mature female produces eggs from the intestine, with the resultant larvae capable of causing autoinfection by penetrating the intestine or perianal skin. The autoinfection stage of strongyloidiasis can cause an itchy, rapidly spreading but transient skin eruption called larva currens. Symptoms can also include cough and abdominal pain, however strongyloidiasis can often be asymptomatic over a period of years. The main worry is the potential for life-threatening strongyloidiasis hyperinfection if a patient becomes immunocompromised. Diagnosis can be made by stool microscopy or serology. Treatment is with standard anti-helminth drugs such as ivermectin or albendazole.