Albendazole
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
The recommended dose of albendazole for Strongyloides stercoralis infection is 400 mg daily for 3 days (Chitchang et al., 1984; Archibald et al., 1993; Liu and Weller, 1993; Beeching and Gill, 1995). Diagnosis, and therefore proof of cure, is problematic in this infection as infective larvae may be present in only low numbers in stool, requiring repeated use of a coproculture method (such as the agar plate method) or specific concentration method (the Baermann method) to reliably diagnose infection. Nineteen studies, including 479 patients, are reported using this 3-day dosing regimen. Cures were seen in 298 patients (62.2%) at 14–21 days post treatment. A number of other regimens have been tested, mostly with multiple day dosing. Although a single 400-mg dose has been reported to be effective in several studies (69.3% cure), follow-up in several of these studies was short, and the parasitologic methods were generally not appropriate for evaluation of strongyloidiasis. Today, ivermectin is considered to be the treatment of choice for single infections with Strongyloides (Liu and Weller, 1993; Datry et al., 1994), with single doses being substantially more effective than even a 7-day course of albendazole (Suputtamongkol et al., 2011). However, if treatment of multiple intestinal helminth infections is required, especially if hookworm is included, albendazole should be used in addition.
The Helminths
Donald L. Price in Procedure Manual for the Diagnosis of Intestinal Parasites, 2017
In addition to eggs of helminths, juvenile worms (larvae) may be found in fecal specimens. Infection with Strongyloides stercoralis occurs throughout tropical and temperate areas of the world but is more prevalent in the warm, wet regions of the tropics. Man is considered to be the typical, definitive host of S. stercoralis, but dogs and cats may also be infected and act as reservoir hosts for man (Georgi and Sprinkle, 1974). The female worms of S. stercoralis inhabit the crypts of the duodenum or the first section of the jejunum where they lay partially embryonated eggs. The juvenile develops rapidly, emerges from the egg, and usually migrates to the intestinal lumen. Juveniles pass down the intestinal tract and are evacuated with the feces.
Parasites and Conservation Biology
Eric S. Loker, Bruce V. Hofkin in Parasitology, 2023
Orangutans (Pongo sp.), thanks in large part to ever-growing oil palm plantations, have suffered severe population reductions and habitat loss in their native range in Borneo and Sumatra and are listed as endangered. They are often infected with intestinal nematodes of the genus Strongyloides, which can develop proliferative infections and may represent a major cause of death in captive individuals. In Borneo, both wild and captive orangutans and a human caretaker were shown to share S. fuelleborni fuelleborni worms, suggestive of the possibility they traded worms back and forth. S. stercoralis, primarily a human parasite, was also found in one orangutan there.
Infectious diseases among Ethiopian immigrants in Israel: a descriptive literature review
Published in Pathogens and Global Health, 2021
Yulia Treister-Goltzman, Ali Alhoashle, Roni Peleg
The EI who came to Israel in 1991 stayed over in refugee camps in Addis Ababa with minimal medical services. In this population the prevalence of intestinal parasites was 75% with 25% having multiple parasites [60]. Severe, unique manifestations of intestinal helminths were described among EI. One 3-year-old boy had an acute abdomen following intestinal necrosis resulting from an intestinal obstruction by Ascaris lumbricoides [61]. Three unusual clinical cases of colonic schistosomiasis were reported in EI. One patient had bloody diarrhea for 3 years, the second had salmonella co-infection, and the third had schistosomal colitis that was found on routine sigmoidoscopy as part of screening [62]. Strongyloides is an intestinal nematode that infests millions of people in the developing world, but much fewer in the developed world. Infection can cause a fatal disease in immunosuppressed patients, sometimes following hyperinfection (accelerated autoinfection). Four cases of Strongyloidiasis in EI were reported from one medical center in Israel over a one-year period. They had different manifestations of severe infection that were seen in the gastrointestinal tract and the lungs with further dissemination to other body systems. Three of these cases ended in death [63].
Overcoming challenges in the diagnosis and treatment of parasitic infectious diseases in migrants
Published in Expert Review of Anti-infective Therapy, 2020
Francesca F. Norman, Belen Comeche, Sandra Chamorro, Rogelio López-Vélez
Infection is acquired through direct penetration of human skin by infective larvae when in contact with contaminated soil during domestic, agricultural, and recreational activities. Strongyloides spp. has a free-living life cycle in soil and a parasitic cycle, which may be maintained for years in the host through repeated replication and auto-infection. Rarely, infections through solid organ transplantation from an infected donor have been reported [106,107]. Infections may range from asymptomatic or mild infections with cutaneous and gastrointestinal symptoms, to severe life-threatening disease due to increased replication and dissemination of larvae. Underlying conditions such as HTLV-1 co-infection and alcoholism have been identified as possible risks for acquisition of Strongyloides stercoralis infection and dissemination [108].
Utility of immunology, microbiology, and helminth investigations in clinical assessment of severe asthma
Published in Journal of Asthma, 2022
Andrew Singer, F. Runa Ali, Simon Quantrill, Nathan North, Mike Stevens, Jonathan Lambourne, Sofia Grigoriadou, Paul E. Pfeffer
Another concern is asymptomatic chronic Strongyloides infection. Strongyloides stercoralis is a parasite endemic to resource-poor tropical and subtropical regions, with an estimated global prevalence of 100 million cases (17). Strongyloides is almost unique amongst parasites in that it can complete its entire life-cycle within the human host and as a result chronic, often asymptomatic, infection can persist for decades after primary infection (17). Immune-mediated control of helminth infection is thought to rely on an intact Th2 immune response (18). With immune suppression, particularly with corticosteroids (19), there is an increased risk of developing hyper-infection, which carries a high mortality. This increased risk also hypothetically applies to anti-Th2 monoclonal antibody therapies. Concerns around the risk of hyper-infection, especially given the high prevalence of Strongyloides sero-positivity within the population that the hospital serves (20), led to introduction of screening patients for asymptomatic Strongyloides infection with an increasing volume of tests as the service grew.
Related Knowledge Centers
- Dermatitis
- Strongyloides Stercoralis
- Ivermectin
- Small Intestine
- Strongylidae
- Strongyloidiasis
- Tiabendazole