Paul Manisha, Meena Suneeta, Gupta Pratima, Jha Sweta, Rekha U Sasi, Kumar V Pradeep
Department of Microbiology, All India Institute of Microbiology, Rishikesh, Uttarakhand, India.
J Family Med Prim Care. 2020 Feb 28;9(2):485-491. doi: 10.4103/jfmpc.jfmpc_1182_19. eCollection 2020 Feb.
Strongyloidiasis is frequently asymptomatic but can cause disseminated disease and variable presentations. Diagnosis is often delayed or misdirected either due to poor degree of clinical suspicion or clinical imitation of other gastrointestinal conditions. This infection is not infrequent and several cases from all over India have been reported barring few states from central India. We reviewed 166 cases published in English literature from India; from 2001 till 2018 including 2 recent cases from our institute. The mean age of presentation was 35 years with male female ratio of 2.8:1. The duration of disease at the time of presentation varied from 15 days to 10 years. Most important predisposing factor identified in the study was HIV (13.3%) and steroid therapy (6.6%). Most common modality of diagnosis was by stool microscopy (69.3%). Radiological investigations were ordered in 33.7% patients before stool microscopy. Ivermectin was the most common treatment regimen with cure rate of 97.6%. Better awareness and early clinical suspicion of the disease with stool microscopy and adequate therapy are necessary to improve the outcome. Strongyloidiasis is rather widely prevalent infection with variable symptomatology and calls for a close coordination from family physicians and microbiologists.
粪类圆线虫病通常无症状,但可导致播散性疾病及多种表现。由于临床怀疑程度低或对其他胃肠道疾病的临床模仿,诊断往往延迟或有误。这种感染并不罕见,印度各地均有病例报道,印度中部少数几个邦除外。我们回顾了2001年至2018年期间印度英文文献中发表的166例病例,包括我们研究所最近的2例。发病时的平均年龄为35岁,男女比例为2.8:1。发病时疾病持续时间从15天到10年不等。研究中确定的最重要的易感因素是艾滋病毒(13.3%)和类固醇治疗(6.6%)。最常见的诊断方式是粪便显微镜检查(69.3%)。33.7%的患者在粪便显微镜检查前进行了影像学检查。伊维菌素是最常见的治疗方案,治愈率为97.6%。提高对该病的认识、早期临床怀疑、粪便显微镜检查及充分治疗对于改善预后很有必要。粪类圆线虫病是一种广泛流行的感染,症状多样,需要家庭医生和微生物学家密切协作。