What are the hematologic findings in strongyloidiasis?

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

The white blood cell (WBC) count is usually within the reference range in acute and chronic strongyloidiasis; it is often elevated in severe strongyloidiasis. Peripheral leukocytosis may occur in the early stages of the infection.

Peripheral eosinophilia (>600/mL) probably represents an immune response to larvae migrating through host tissues. This finding is common during acute infection (10-40% to as high as 75-80%), intermittent during chronic infection (often the only abnormal laboratory test result), and frequently absent in severe strongyloidiasis and in the immunocompromised host. A normal eosinophil count with an untreated known Strongyloides infection may be a poor prognostic sign.

Severe infection may be associated with anemia, thrombocytopenia, and a prolonged prothrombin time (PT) because of decreased levels of clotting factors.

Obtain blood cultures in all patients in whom Strongyloides infection is suspected, because enteric pathogens often cause coinfection, most commonly Escherichia coli and Klebsiella species.


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