What are the approach considerations in the workup of strongyloidiasis?

Updated: Jun 20, 2019
  • Author: Pranatharthi Haran Chandrasekar, MBBS, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Identify patients at risk for strongyloidosis, and perform appropriate diagnostic tests before they begin immunosuppressive therapy. Search for S stercoralis larvae before initiating immunosuppression in anyone who has traveled to an endemic area, even if it was decades earlier. [7]

In patients with an appropriate geographic history, rule out strongyloidiasis by means of thorough evaluation, including several stool examinations for ova and parasites, special larvae detection techniques, and/or serology in all transplant candidates or others who are likely to receive a prolonged course of steroids or other immunosuppressive medications. Complete eradication of the parasite before the initiation of immunosuppressive therapy is essential in patients with uncomplicated infections to ensure that hyperinfection syndrome does not develop. In general, falling eosinophilia and Strongyloides antibody titers are indications of successful treatment.


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