What is the role of a string test (Entero-Test) or duodenal aspiration test 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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This test offers than simple stool examination.

Conduct an Entero-Test (string test) or a duodenal aspiration to examine duodenal fluid for Strongyloides species larvae. These tests produce a higher likelihood of larval recovery than a stool examination. However, results may be negative if larvae are located too far down in the lower intestine. The reported sensitivity ranges from 40% to 90%.

The Entero-Test capsule consists of a textured string within a gelatin capsule. One end of the string is taped to the cheek and the capsule is swallowed; after several hours or overnight, the terminal portion of the string ideally unravels into the duodenum. If it does, the end of the string should be bile stained, and mucous secretions can be wiped onto a slide using gloved hands. Examination of the slide should reveal larvae.

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