What is the role of anthelmintic agents in the treatment of strongyloidiasis?

Updated: Jun 20, 2019
  • Author: Pranatharthi Haran Chandrasekar, MBBS, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Strongyloides infection should be suspected in a patient with nonspecific gastrointestinal, respiratory, or recurrent dermatologic symptoms of unclear etiology with risk factors for Strongyloides infection. Conduct definitive treatment with anthelmintic drugs, although these medications target adult worms and are not very effective against larvae in the initial infection.

Strongyloides infections should be treated even in the absence of symptoms as hyperinfection syndrome carries a high mortality rate. Disseminated strongyloidiasis requires treatment for at least 7 days or until the parasite can no longer be identified in clinical specimens. Concomitant infections should be treated aggressively, and any immunosuppressants, including exogenous corticosteroids, should be quickly tapered. [71] Corticosteroid therapy must be avoided, because hyperinfection and death may occur.

Anthelmintic treatment may have to be repeated or the duration prolonged in patients with hyperinfection syndrome. Relapses may occur despite proper therapy.

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