What stool culture techniques are available for 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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Several specialized stool culture techniques have been advanced that exploit the ability of S stercoralis to enter a free-living cycle of development. In all of these methods, fecal material is cultured in a vessel for approximately 1 week, during which filariform larvae crawl out of the stool suspension. [28]

Enhance larvae recovery by using special methods such as the Baermann funnel method (larvae migrate from stool samples to warmed water and are detected in the centrifuged fluid), the Harada-Mori filter paper method (stool is spread onto a filter paper strip and cultured in a test tube containing a little water; filariform larvae appear in the water after 7-10 d), and the agar plate method, when needed. The modified agar plate method appears to be the most sensitive and efficient method.

Charcoal fecal culture (26°C) for 1 week, using the Baermann concentration method, is best for detecting hatched larvae. However, the availability of this cumbersome test in clinical practice is highly variable. False-positive test results can occur in patients with hookworm infection.

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