What are the endoscopic and histologic features of strongyloidiasis?

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

Findings from upper and lower gastrointestinal endoscopy may range from normal-appearing mucosa to severe duodenitis and colitis. The most common abnormal duodenal endoscopic finding is edematous mucosa, white villi, and erythematous mucosa. In some cases, the larvae are identified with duodenal biopsy. [66]

Duodenal biopsy histopathologic examination identified larvae in 71.4% of immunosuppressed patients. [66] Thus, in addition to stool analysis, endoscopic observation and biopsies are very important. [67]

Strongyloides stercoralis larvae are typically found in the proximal part of the small intestine, embedded in the mucosal lamina propria, where they produce mild to moderate degrees of edema, cellular infiltration, partial villous atrophy, and, occasionally (in severe strongyloidiasis), ulcerations. In long-standing infections, fibrosis may develop.


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