1. Albendazole 2. Pipperazine citrate 3. Mebendazole or pyrantel pamoate

Strongyloides Stercolaris Flashcards by Kyra Catedral

Common name:
SS

● Threadworm
● Cochin-China Diarrhea ○ Cochin-China → Vietnam

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Facultative parasite

● (rhabditiform)

● (filariform female)

Free-living form

Parasitic form

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MALE SS

● Smaller the female measuring 0.7mm x 0.04mm

● Ventrally____ tail,___ copulatory spicules, a____, no_____

● Parasitic males are not reliably identified

curved/ two/ gubernaculum/ caudal alae

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Female parasitic SS

● what color? with a finely striated cuticle, measuring 2.2mm x 0.04mm

● Reproduction:____

● Anterior:
○ Slender, tapering

● Posterior:
○ Short, conical, pointed tail

● Short buccal cavity with____ indistinct lips

● Long, slender esophagus extending to the anterior fourth of the body

● Intestine is continuous to the subterminal anus

● Vulva at one-third the length of the body from posterior end

● Uteri contain single file of 9-12 ova

Colorless, semi-transparent

Parthenogenesis

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Free living female SS

● Reproduction:_____

● Smaller than parasitic female measuring 1mm x 0.06mm

● Muscular double-bulbed esophagus

● Intestine is straight cylindrical tube

Oviparous

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Phasmid/ Aphasmid?

Phasmid

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Hosts SS

Humans/ monkey

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MOT SS

Skin penetration

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Infective stage SS

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Diagnostic stage SS

Rhabditiform

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Diagnosis SS

● DFS

● Concentration techniques (FECT)

● Baermann Funnel Gauze method

● Harada-Mori culture

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Treatment SS

Albendazole
Pipperazine citrate
Mebendazole or pyrantel pamoate

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• Colorless, semi-transparent, with a finely striated cuticle, measuring 2.2mm x 0.04mm

Parasitic Female

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Parasitic female

Anterior:
Posterior:

• Slender, tapering

• Short, conical, pointed tail

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Parasitic Female

•_____ buccal cavity with___ indistinct lips

•______ esophagus extending to the anterior fourth of the body

•______ is continuous to the subterminal anus

•_____ at one-third the length of the body from posterior end

• Uteri contain single file of ____ ova

Short; 4

Long, slender

Intestine

Vulva

9-12 ova

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Free-Living Female

• Reproduction:

Oviparous

Parasitic Female

• Reproduction:

Parthenogenesis

Free-Living Female

•_____ than parasitic female measuring 1mm x 0.06mm

• Muscular_____ esophagus

•_____ is straight cylindrical tube

Smaller

double-bulbed

Intestine

Free-Living Male

• Smaller the female measuring 0.7mm x 0.04mm

•——- curved tail,_____ copulatory spicules, a______, no_____

• *Parasitic males are____

Ventrally; two; gubernaculum; caudal alae

not reliably identified

Rhabditiform Larva

• Short buccal cavity, prominent genital primordium

Strongyloides stercoralis

Rhabditiform

• Long buccal cavity, small genital primordium

Hookworm

Filariform Larvae

• Short esophagus
• Pointed tail

• Hookworms

Filariform larva

• Long esophagus
• Notched tail

Strongyloides stercoralis

Ovum
Morphology

• Clear, thin, shell similar to hookworms

Life cycle Three Phases of Acute Infection 1. Invasion of the___ by the_____ 2. Migration of larvae through the___ 3. Penetration of the ______by adult female worms

skin; filariform larvae body intestinal mucosa

Skin • Larva____ •_________ skin lesion at the side of entry caused by rapid moving filariform larva • With_____&_____

currens Erythematous serpiginous pruritus and urticaria

Migration of Larva •_____ • Destroyed causing _______with hemorrhage • Cough and tracheal irritation mimicking____

Lungs lobar pneumonia bronchitis

: may be asymptomatic

• Light infection

: diarrhea alternating with constipation

Moderate infection

: intractable, painless, intermittent diarrhea characterized by episodes of watery and bloody stools (CochinChina Diarrhea)

Heavy infection

: syndrome of accelerated autoinfection usually among immunocompromised • Exacerbation of GIT and RT symptoms • Increased number of larvae in stool samples and even in sputum

Hyperinfection

Intestine •_________ • Often asymptomatic • May have intermittent vomiting, diarrhea, constipation, and borborygmi • Anal pruritus, urticaria, larva currens • Recurrent asthma, nephritic syndrome

Chronic strongyloidiasis

Complications

• Edema, emaciation, anorexia, anemia, lobar pneumonia, ileus, intestinal obstruction, gastrointestinal bleeding, malabsorption

Diagnosis Clue: unexplained______

eosinophilia

Diagnosis Culture method

• Harada-Mori culture • Nutrient agar plate

Concentration techniques Others:

Duodenal aspiration Beale’s string test small bowel biopsy

Anti-helminths • ______\contraindicated in pregnant women •______: best for chronic uncomplicated strongyloidiasis

Albendazole, thiabendazole Ivermectin