Diagnostic Tests

Though relatively insensitive, the stool can be examined in wet mounts:


The duodenal fluid can be examined using techniques such as the Enterotest string or duodenal aspiration. Larvae may be detected in sputum from patients with disseminated strongyloidiasis (2,3).

 

Treatment and Prevention

The goal of treatment is to eliminate the worms with anti-worm medications (anthelmintics) such as thiabendazole (2). The CDC recommends treating Strongyloidiasis with ivermectin, with thiabendazole as an alternative (3). The recommended dosage is as follows (4):

All patients who are at risk of disseminated strongyloidiasis should be treated. Full recovery with eradication of parasites is expected with adequate treatment, but complications may include acute pulmonary eosinophilia (Loeffler's syndrome) and malabsorption (2).

Prevention and control of strongyloidiasis is clearly dependent upon improving economic circumstances with installation of adequate human waste disposal systems and reliable water supplies (4). As additional preventive measures, one should (5):

1. Dispose of human feces in a sanitary manner
2. Practice rigid hygienic habits, including the use of footwear in endemic areas
3. Rule out strongyloidiasis before initiating immunosuppressive therapy
4. Examine and treat all infected dogs, cats, and monkeys that are in contact with people.

 

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