Strongyloides

Question 1

Strongyloidiasis is an infection caused by Strongyloides stercoralis, a parasitic worm. What is the estimated global prevalence of this?

1 - 2500-100,000
2 - 500,000 - 1 million
3 - 30–100 million
3 - 100-300 million

Answer 1

3 - 30–100 million

Likely to be a lot more though

Question 2

How is strongyloidiasis is an infection caused by Strongyloides stercoralis, a parasitic worm transmitted?

1 - in fresh water through the urethra
2 - through skin form contaminated soil
3 - contaminated food and water
4 - sexual contact, specifically anal sex

Answer 2

2 - through skin form contaminated soil

Human skin by infective larvae when in contact with soil

People who walk barefoot are likely to contract this

Question 3

In which of the following climates is strongyloidiasis most likely to occur?

1 - tropical climates
2 - temperate climates
3 - sub-tropical climates

Answer 3

1 - tropical climates

But can occur in any of these

Question 4

Once infected by the larvae, where do strongyloidiasis migrate to?

1 - liver
2 - intestines
3 - spleen
4 - kidneys

Answer 4

2 - intestines

• Here they mature into adults and produce eggs
• The eggs hatch in the gut lumen and yield larvae that are evacuated in faeces

Question 5

Once infected and in the small intestines, do all of the strongyloidiasis parasite get excreted out?

Answer 5

• No

Some are able to penetrate the perianal skin and perpetuate the infection

Question 6

What are the most common symptoms of strongyloidiasis?

1 - abdominal pain and diarrhoea
2 - cough
3 - wheezing, chronic bronchitis with diffuse pulmonaryinfiltrate
4 - pruritus and urticaria
5 - weight loss/malabsorption
6 - all of the above

Answer 6

6 - all of the above

Question 7

Do all patients with strongyloidiasis elicit signs of infection?

Answer 7

• No

Can be mild symptoms, i.e. lung involvement due to migration of larvae

Question 8

The following are the most common symptoms of strongyloidiasis

• abdominal pain and diarrhoea
• cough
• wheezing, chronic bronchitis with diffuse pulmonaryinfiltrate
• pruritus and urticaria
• weight loss/malabsorption
• all of the above

Are these symptoms constant or intermittent?

Answer 8

• Intermittent

Question 9

Strongyloidiasis typically leads to mild symptoms, but in some cases the infection can be severe and life-threatening. Which of the following patients are most at risk of severe and dangerous strongyloidiasis?

1 - patient has just received a renal transplant
2 - COPD or Asthma patients
3 - Hepatitis B patients
4 - Patients >55 years old

Answer 9

1 - patient has just received a renal transplant

Strongyloidiasis can be very dangerous in immunocomprimised patients

Question 10

What is typically the 1st line test to diagnose patients with Strongyloidiasis?

1 - stool sample/culture and microscopy
2 - ELISA for surface antigens
3 - real time PCR for viral load
4 - bronchoalveolar lavage

Answer 10

1 - stool sample/culture and microscopy

Detection ofStrongyloideslarvae in stool specimens using direct microscopy, concentration methods (e.g., formalin-ethyl acetate concentration), or agar plate culture.

Question 11

What is the first line treatment of choice in Strongyloidiasis?

1 - Azithromycin
2 - Ivermectin
3 - Vancomycin
4 - Penicillin

Answer 11

2 - Ivermectin

Typically given as a single dose, but may be given as multiple if required