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PubMed1994

[Organ changes in experimental strongyloidosis of rabbits provoked by Strongyloides papillosus].

Strongyloidosis was induced by percutaneous injection of rabbits; then organ changes were tested. It has been found that Strongyloides papillosus evoked changes in intestine, liver, kidney and lung. No notable changes were found in heart, spleen and suprarenal gland. These changes may be provoked not only directly by the presence of these parasites but also by the products of metabolism of S. papillosus.

Animals↗
PubMedDate not supplied

Cytologic detection of strongyloides stercoralis in a routine cervicovaginal smear. A case report.

A 28-year-old, lactating woman came for a routine checkup. Her cytologic smear revealed a single larva of Strongyloides stercoralis. On reviewing the literature on parasites encountered in cytologic smears, S stercoralis was found to be extremely rare. Our case is probably the second in the world and the first reported from India. A review of the literature on various parasites encountered in the cytologic smear is presented.

Adult↗
PubMed1994

Adherence of monocytes and polymorphonuclear cells to infective larvae of Strongyloides stercoralis after complement activation.

The activation of the complement system by living Strongyloides stercoralis filariform larvae and their antigenic preparation was demonstrated in vitro through both classical and alternative pathways. This activation does not require the presence of specific antibodies but promotes the adhesion of peripheral blood monocytes (MNC) and polymorphonuclear cells (PMNC) to the larval surface. Larvae, totally coated by PMNC, showed a visible loss of motility after 2 hr incubation. Ethylenediamine tetraacetic acid, in contrast to ethylene glycol-bis beta-aminoethylether N,N,N,N-tetraacetic acid, abolished the adherence activity, suggesting the involvement of the alternative pathway in this process. Deposition of complement components C1q, C3, C4, C8, and properdin on the larval surface was demonstrated by immunofluorescence assays. In addition, complement activation by the larvae was demonstrated through C3 conversion and C4 cleavage assays, both depending on the number of larvae. On the other hand, complement activation by S. stercoralis antigen was determined by factor B and C4 cleavage, as well as C3 conversion assays. Our results suggest that the complement system as a first line of defense, in association with the effector cells, plays an important role in the nonspecific immune response of the host to S. stercoralis infection, especially considering the constant parasite recycling through the host tissues.

Animals↗
PubMed1993

Intestinal protection against Strongyloides ratti and mastocytosis induced by administration of interleukin-3 in mice.

Information about interleukin-3 (IL-3) effects in vivo is limited compared with the in vitro effects. We found that a repetitive injection of a low dose of recombinant IL-3 induced protection against intestinal worms of Strongyloides ratti in C57BL/6 mice. When mice were injected i.p. with different doses of recombinant IL-3 twice a day from day -5 to day -1 and infected orally with larvae recovered from the head of infected rats on day 0, worm recovery from the small intestine was markedly reduced by a total of 10(4) U IL-3 or more on day 2 post-infection. The number of intestinal mucosal mast cells (MMC) was increased by the protective dose of IL-3. The IL-3 treatment, however, was ineffective in protecting mice against tissue migrating larvae, as assessed by recovery from the head. The protective effect of IL-3 on intestinal worms was observed within 6 hr post oral infection, suggesting little concern with antigen-specific immune responses. The effective dose of IL-3 treatment increased the number of MMC progenitors five times in the spleen and the mesenteric lymph nodes. An MMC-specific protease, MMCP-1, was secreted 200 times more than in controls in the intestinal lumen by the IL-3 treatment. The IL-3 treatment induced no protection or mastocytosis in mast cell-deficient W/Wv mice. These results suggest that the IL-3-induced intestinal protection against S. ratti is mediated by MMC.

Animals↗
PubMedDate not supplied

[Strongyloides stercoralis hyperinfection with encephalitis manifestations].

A case of encephalitis in a 34 year old woman from Ivory Coast, referred to the Santo Spirito Hospital in Rome, is reported. During a coma which appeared terminal, a bronchoaspirate done for suspicious pulmonary TB, revealed many filariform larvae of Strongyloides stercoralis. A treatment with albendazole has rapidly ameliorated the situation but a relapse after 4 months caused the obitus of the patient.

Adult↗
PubMed1993

Evaluation of three methods for laboratory diagnosis of Strongyloides stercoralis infection.

The direct smear, a modified Baermann technique, and the agar plate culture method were compared for cost and efficiency in recovering Strongyloides stercoralis larvae in a hospital setting in Honduras. Of 427 stool samples, 9 were positive by the direct smear and 33 additional ones were detected by the Baermann technique; the agar plate culture method disclosed 28 more cases for a total of 70 S. stercoralis infections. The modified Baermann method was 3.6 times more efficient than the direct smear, and the agar plate culture increased the modified Baermann efficiency by 0.8 times. Cost for materials alone was cheapest for the direct smear; it increased 4 times for the modified Baermann method and 15 times for the agar plate culture method. This last technique required a better equipped laboratory, more time to perform, and the best trained, most skillful laboratory personnel. In field studies, prevalence of infection should determine the cost-effectiveness of the agar plate culture method; in a clinical setting, when S. stercoralis infection must be ruled out, the agar plate culture method should be made available to the medical community.

Animals↗
PubMedDate not supplied

[Strongyloides stercoralis hyperinfection syndrome in a patient with human immunodeficiency virus (HIV) infection: report of a case and review of the literature].

A case of a twenty-one year old woman with Strongyloides stercoralis hyperinfection associated with human immunodeficiency virus infection that represents the fifteen case reported in the literature is here presented. Hypothesis for which this association is infrequent and several therapeutic alternatives are reviewed.

Adult↗
PubMedDate not supplied

Cryptosporidium, isospora and strongyloides in AIDS.

BACKGROUND: Diarrhoea is a common presentation in patients with AIDS. It occurs due to a number of parasites which are seldom seen in immunocompetent hosts. METHODS: Between January 1993 and July 1994, faecal specimens from 77 patients with AIDS presenting with diarrhoea of more than a month's duration were examined by direct wet mount microscopy of saline and iodine preparations and by the modified Ziehl-Neelsen stain. RESULTS: Cryptosporidium, Isospora and Strongyloides stercoralis alone or in combination were present in 29 of the 77 patients. CONCLUSION: The presence of these parasites highlights their pathogenic potential for immunocompromised patients with AIDS. Diarrhoea due to Isosporais responsive to treatment, hence their identification has therapeutic implications as well.

AIDS-Related Opportunistic Infections↗
PubMed1996

Strongyloides stercoralis hyperinfection in a case of idiopathic pulmonary fibrosis.

The Strongyloides stercoralis infection is a prominent cause of death in many areas of the world. A 64-year-old man with pulmonary fibrosis was admitted to the hospital because of progressive shortness of breath and increasing cough. The patient had been previously admitted for his illness and had a remarkable immunosuppression due to the use of steroids (CD4+ lymphocytes = 200 x 10(6)/l). Repeated sputum and stool studies were diagnostic for strongyloidiasis. The patient died suddenly from severe cardiorespiratory failure while he was under mebendazole treatment (100 mg b.i.d.). Strongyloidiasis occurs mostly in immunocompromised hosts, as in patients with chronic pulmonary diseases on long-term treatment with corticosteroids, oncology patients under treatment and patients with AIDS.

Adrenal Cortex Hormones↗
PubMed1996

Pulmonary hyperinfection with Strongyloides stercoralis.

Strongyloides stercoralis is an intestinal parasite in humans. Infected patients may be asymptomatic or have mild to moderate abdominal symptoms. It may spread to the lungs and, finally, disseminate in the immunocompromised patient. S. stercoralis is an important cause of severe pulmonary infection and death in many areas of the world. Here we describe an 87-year-old man with S. stercoralis pulmonary hyperinfection. He had respiratory failure with severe abdominal distention. Chest x-ray showed infiltration over the right upper lung field. Papanicolaou stain of sputum demonstrated the rabditiform larvae of S. stercoralis. Stool examination revealed S. stercoralis larvae and eggs. He received two courses of albendazole treatment, but died 5 weeks after admission from Gram-negative bacteremia. This case is a classic presentation of the S. stercoralis pulmonary hyperinfection syndrome.

Aged↗
PubMed1996

[Strongyloides stercoralis hyperinfection].

Strongyloides stercoralis (SS) is an intestinal nematode which infects a large proportion of tropical and subtropical populations. The endemic areas are southeast Asia, South America and sub-Saharan Africa. Infection is acquired when the worms penetrate the skin, pass via the blood stream to the lungs, ascend the respiratory tract, are swallowed and grow into adult worms in the mucosa of the small intestine. The eggs laid by the female release larvae which pass down the lumen and reach the soil via the feces. While passing down the intestinal tract, a few of the rhabditiform larvae may be transformed into infective filariform larvae which can penetrate the distal intestinal and anal mucosa, returning to the blood stream. This "autoinfection" cycle is unique to SS, and explains why the infection can be perpetuated without further exposure to exogenous, infective larvae and can persist decades after departure from endemic areas. A substantial proportion of those affected are asymptomatic, but overwhelming infection may occur in immunosuppressed patients. This "hyperinfection" state is characterized by severe gastrointestinal and respiratory tract involvement, along with skin rash, Gram-negative bacteremia and cerebral signs. While frequently fatal, it is curable when diagnosed and treated promptly. We present a 79-year-old woman with idiopathic polymyositis, who was immunosuppressed by prolonged corticosteroid treatment. Her illness was complicated by SS hyperinfection. Diagnosis was made from stool and bronchial smears. Treatment with thiabendazole was started early and within a week there was complete cure. This is the fourth reported case of SS hyperinfection treated in Israel.

Aged↗
PubMed1997

Passive transfer of immune serum reduces the L1/adult ratio of worms recovered from the intestines of Strongyloides stercoralis-infected gerbils.

In Strongyloides stercoralis-infected gerbils it had been observed previously that the ratio of first-stage larvae to adult worms decreases after 3 wk of infection. Serum obtained from gerbils after this decrease in fecundity, but before worms were expelled, was transferred passively to other infected gerbils during the peak of worm fecundity. The immune serum caused a significant decrease in the L1/adult ratio but had no effect on the number of uterine eggs, the length, or the intestinal and ovarian ultrastructure of adult worms. Apparently a factor(s) in the immune serum either killed eggs, after oviposition, or the hatched larvae, without damaging the adult worms.

Animals↗
PubMed1997

Colonic Strongyloides stercoralis infection masquerading as ulcerative colitis.

Strongyloides stercoralis is a nematode infection which predominantly involves the small bowel. Spillover infection to the colon does occur, but is uncommon and is usually associated with an immunocompromised host. Accurate diagnosis is essential and, as this case demonstrates, a long history does not preclude an infective aetiology.

Animals↗
PubMed1997

An evaluation of the modified agar plate method for diagnosis of Strongyloides stercoralis.

An examination of 320 random stool samples from patients aged 7-60 years in Kafr-Sakr Hospital, was done to compare the efficacy of modified agar plate method to traditional method for diagnosis of Strongyloides stercoralis infection. Out of 320 cases examined 27 were positive for strongyloidiasis by all means. The traditional methods detected 37% and 48.1% from the positive cases by single and repeated 3 days examination respectively. The modified agar plate detected 70.3% and 96.2% among positive cases by single and 3 days examination respectively. The modified agar plate was twice efficient than the traditional methods. Precautions taken to obtain the best result were discussed. Considering the other advantages of this technique, it was concluded that it may eventually become the test of choice in diagnosis of strongyloidiasis.

Adolescent↗
PubMed1997

[Infection by Strongyloides stercoralis in the county of Safor, Spain].

BACKGROUND: Strongyloides stercoralis is an endemic nematode in tropical and subtropical regions, but almost unknown in Spain. PATIENTS AND METHODS: In order to know some epidemiological, clinical and analytic features of this infection in our area (La Safor, Valencia), we performed a prospective study for 19 months. Through the search for the parasite in feces of patients with eosinophilia, we identified 37 subjects who were studied at diagnosis and 4 months later. RESULTS: Thirty-three patients (89%) were currently, or had been agricultural workers, and thirty had worked barefooted and/or had drunk contaminated irrigation water. Twenty-three patients (62%) had a chronic or immunosuppressive diseases, and two of them on steroid treatment, developed a disseminated strongyloidiasis. Thirteen patients (35%) were asymptomatic; the rest had clinical manifestations attributed S. stercoralis, mainly digestive. Two of the patients with disseminated strongyloidiasis also had concomitant bacterial infections by Streptococcus bovis, Streptococcus faecalis and Enterobacter sp. At diagnosis, besides eosinophilia, 86.5% had raised levels of IgE. Four months later treatment, the number of eosinophils was normal and IgE levels significantly decreased. The diagnostic yield of parasitic study of feces was increased with the number of samples examined. Thiabendazole achieved erradication of the parasite in 35 patients, and the other two died because of disseminated strongyloidiasis. CONCLUSIONS: The presence of eosinophilia in patients from rural areas with subtropical climate should raise suspicion about infection by S. stercoralis, which, although sometimes is asymptomatic, may cause systemic bacterial infections in cases of hyperinfestation, specially when glucocorticoid treatment is given.

Aged↗
PubMed1997

Barren female Strongyloides stercoralis from occult chronic infections are rejuvenated by transfer to parasite-naive recipient hosts and give rise to an autoinfective burst.

It is widely assumed that barren Strongyloides stercoralis occurring in chronically infected carriers can become fecund when immunity wanes. Evidence for this involves corticosteroid treatment of hosts harboring occult infections that subsequently return to patency. However, nematodes have ecdysteroid receptors, and it has been suggested that corticosteroids act directly on the parasite, inducing autoinfective development, rather than indirectly by suppressing host immunity. To test these competing concepts, barren females were recovered from donor dogs when the dogs' fecal examinations turned negative. Groups of 100 active barren worms were surgically transplanted into the small intestines of each of 6 naive canine recipients. Three were examined at necropsy at 4-5 days postinfection (PI), before autoinfection could amplify the number of successfully transferred parasites. The remaining recipients were examined 21-22 days PI when, if autoinfection had occurred, the worm populations should have increased. At 4-5 days, gravid worms occurred in each of the recipients (19 +/- 6 worms/dog). By 21-22 days, a remarkable population increase had occurred (522.6 +/- 296 worms/dog). Worms from chronically infected donors were stunted, and electron microscopy revealed damage to the intestine and ovaries. Successfully transplanted worms recovered at days 4-5 PI were ovigerous and less stunted and showed repair of intestinal and ovarian tissues.

Animals↗
PubMed1997

Sensory neuroanatomy of a skin-penetrating nematode parasite Strongyloides stercoralis. II. Labial and cephalic neurons.

Host recognition, contact, and skin-penetration by Strongyloides stercoralis infective larvae are crucially important behavioral functions mediating transition from free-living to parasitic life. The sensilla of the worm's anterior tip presumably play an important role in these processes. Besides the main chemosensilla, the amphids, which are of central importance, the larva has 16 putative mechanosensilla. There are six inner labial sensilla: two dorsal, two ventral, and two lateral. The two dorsal and ventral pairs are each innervated by two neurons, whereas each lateral sensillum is singly innervated. The six outer labial and four cephalic sensilla are all singly innervated. All of these have the characteristics of mechanoreceptors: they are closed to the external environment, and closely associated with the overlying cuticle. Distally, their dendritic processes contain granular material and associated microtubules. With two exceptions, the relevant neuronal cell bodies lie in lateral ganglia adjacent to the nerve ring, their positions remarkably similar to those of their homologues in the free-living nematode, Caenorhabditis elegans. Cell bodies of two neuronal pairs, one of two dorsal inner labial neurons and one of two ventral inner labial neurons per side, are however, found far anterior to the remaining cell bodies. All labial and cephalic sensilla are apparently mechanoreceptors, complementing the well-developed chemosensilla. Presumably infective larvae require touch and stretch receptors, not only to initiate skin penetration by finding irregularities as points of access, but also to bore through tissue to reach their ultimate enteral destination.

Animals↗