Strongyloidiasis differential diagnosis: Difference between revisions

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{{CMG}} ; {{AE}} {{ADG}}
{{CMG}} ; {{AE}} {{ADG}}
==Overview==
==Overview==
Strongyloidiasis can mimic other worm infections, and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, and bile duct stone.<ref name="pmid25121962">{{cite journal |vauthors=Puthiyakunnon S, Boddu S, Li Y, Zhou X, Wang C, Li J, Chen X |title=Strongyloidiasis--an insight into its global prevalence and management |journal=PLoS Negl Trop Dis |volume=8 |issue=8 |pages=e3018 |year=2014 |pmid=25121962 |pmc=4133206 |doi=10.1371/journal.pntd.0003018 |url=}}</ref>
[[Strongyloidiasis]] can mimic other [[worm]]  , and also [[Gastrointestinal bleeding|gastrointestinal]] [[Pathology|pathologies]] like [[peptic ulcer disease]], [[intussusception]] in children, and [[bile duct]] stone.<ref name="pmid25121962">{{cite journal |vauthors=Puthiyakunnon S, Boddu S, Li Y, Zhou X, Wang C, Li J, Chen X |title=Strongyloidiasis--an insight into its global prevalence and management |journal=PLoS Negl Trop Dis |volume=8 |issue=8 |pages=e3018 |year=2014 |pmid=25121962 |pmc=4133206 |doi=10.1371/journal.pntd.0003018 |url=}}</ref>


==Differentiating Strongyloidiasis from the diseases==
==Differentiating Strongyloidiasis from the diseases==
Strongyloidiasis can mimic other worm infections, and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, bile duct stone, etc.
[[Strongyloidiasis]] can mimic other [[worm]] [[infections]], and also [[gastrointestinal]] [[Pathology|pathologies]] like [[peptic ulcer disease]], [[intussusception]] in children, [[Bile duct|bile duc]]<nowiki/>t stone, etc.
{| class="wikitable"
{| class="wikitable"
! colspan="7" |Differentiating Enterobiasis from other Nematode infections<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref><ref name="Murray and Nadel's Textbook of Respiratory Medicine">{{cite book |last1=Kim |first1=Kami |last2=Weiss |first2=Louis |last3=Tanowitz |first3=Herbert |title=Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition |publisher=Elsevier |date=2016 |pages=682-698 |chapter=Chapter 39:Parasitic Infections |isbn=978-1-4557-3383-5}}</ref>
! colspan="7" |Differentiating Enterobiasis from other Nematode infections<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref><ref name="Murray and Nadel's Textbook of Respiratory Medicine">{{cite book |last1=Kim |first1=Kami |last2=Weiss |first2=Louis |last3=Tanowitz |first3=Herbert |title=Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition |publisher=Elsevier |date=2016 |pages=682-698 |chapter=Chapter 39:Parasitic Infections |isbn=978-1-4557-3383-5}}</ref>
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! style="background:#4479BA; color: #FFFFFF;" |Treatment
! style="background:#4479BA; color: #FFFFFF;" |Treatment
|-
|-
| align="center" style="background:#DCDCDC;" |[[Ascaris lumbricoides]]
| style="background:#DCDCDC;" align="center" |[[Ascaris lumbricoides]]
|Ingestion of infective ova
|Ingestion of infective [[ova]]
|No
|No
|1-2 years
|1-2 years
|
|
* [[Löffler's syndrome]] (usually about 9-12 days after exposure to ova)
* [[Löffler's syndrome]] (usually about 9-12 days after exposure to [[ova]])
* [[Cough]]
* [[Cough]]
* Substernal discomfort
* [[Substernal pain|Substernal]] discomfort
* [[Crackles]]
* [[Crackles]]
* [[Wheezing]]
* [[Wheezing]]
* Transient opacities
* Transient [[Opacity|opacities]]
|Free in the lumen of the small bowel
|Free air in the [[lumen]] of the [[small bowel]]
(primarily jejunum)
(primarily [[jejunum]])
|
|
* [[Albendazole]]
* [[Albendazole]]
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* [[Piperazine]]
* [[Piperazine]]
|-
|-
| align="center" style="background:#DCDCDC;" |[[Trichuris trichiura]]
| style="background:#DCDCDC;" align="center" |[[Trichuris trichiura]]
(whipworm)
([[whipworm]])
|Ingestion of infective [[ova]]
|Ingestion of infective [[ova]]
|No
|No
|1-3 years
|1-3 years
|
|
* No pulmonary migration, therefore, no pulmonary manifestation
* No [[pulmonary]] migration, therefore, no pulmonary manifestation
|Anchored in the superficial mucosa of cecum and colon
|Anchored in the superficial [[mucosa]] of [[cecum]] and [[colon]]
|
|
* [[Albendazole]]
* [[Albendazole]]
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* [[Mebendazole]]
* [[Mebendazole]]
|-
|-
| align="center" style="background:#DCDCDC;" |[[Hookworm]]  
| style="background:#DCDCDC;" align="center" |[[Hookworm]]  
([[Necator americanus]] and [[Ancylostoma duodenale]])
([[Necator americanus]] and [[Ancylostoma duodenale]])
|Skin penetration by filariform larvae
|[[Skin]] penetration by filariform larvae
|No
|No
|
|
* 3-5 years (Necator)
* 3-5 years ([[Necator americanus|Necator]])
* 1 year (Ancylostoma)
* 1 year ([[Ancylostoma]])
|
|
* [[Löffler's syndrome]]
* [[Löffler's syndrome]]
* Transient opacities
* Transient opacities
|Attached to the mucosa of mid-upper portion of the [[small bowel]]
|Attached to the [[mucosa]] of mid-upper portion of the [[small bowel]]
|
|
* [[Albendazole]]
* [[Albendazole]]
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* [[Pyrantel pamoate]]
* [[Pyrantel pamoate]]
|-
|-
| align="center" style="background:#DCDCDC;" |[[Strongyloides stercoralis]]
| style="background:#DCDCDC;" align="center" |[[Strongyloides stercoralis]]
|Filariform larvae penetrate skin or bowel mucosa  
|Filariform larvae penetrate [[skin]] or [[bowel]] [[mucosa]]
|Yes
|Yes
|
|
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* [[Thiabendazole]]
* [[Thiabendazole]]
|-
|-
| align="center" style="background:#DCDCDC;" |[[Enterobius vermicularis]]  
| style="background:#DCDCDC;" align="center" |[[Enterobius vermicularis]]  
([[pinworm]])
([[pinworm]])
|Ingestion of infective [[ova]]
|Ingestion of infective [[ova]]
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|
|
* Extraintestinal migration is very rare<ref name="pmid21879805">{{cite journal| author=Serpytis M, Seinin D| title=Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys. | journal=Scand J Urol Nephrol | year= 2012 | volume= 46 | issue= 1 | pages= 70-2 | pmid=21879805 | doi=10.3109/00365599.2011.609834 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21879805  }} </ref>
* Extraintestinal migration is very rare<ref name="pmid21879805">{{cite journal| author=Serpytis M, Seinin D| title=Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys. | journal=Scand J Urol Nephrol | year= 2012 | volume= 46 | issue= 1 | pages= 70-2 | pmid=21879805 | doi=10.3109/00365599.2011.609834 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21879805  }} </ref>
|Free in the lumen of [[cecum]], [[appendix]], adjacent [[colon]]
|Free air in the lumen of [[cecum]], [[appendix]], adjacent [[colon]]
|
|
* [[Albendazole]]
* [[Albendazole]]

Revision as of 16:01, 30 June 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Strongyloidiasis can mimic other worm , and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, and bile duct stone.[1]

Differentiating Strongyloidiasis from the diseases

Strongyloidiasis can mimic other worm infections, and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, bile duct stone, etc.

Differentiating Enterobiasis from other Nematode infections[2][3]
Nematode Transmission Direct Person-Person Transmission Duration of Infection Pulmonary Manifestation Location of Adult worm(s) Treatment
Ascaris lumbricoides Ingestion of infective ova No 1-2 years Free air in the lumen of the small bowel

(primarily jejunum)

Trichuris trichiura

(whipworm)

Ingestion of infective ova No 1-3 years
  • No pulmonary migration, therefore, no pulmonary manifestation
Anchored in the superficial mucosa of cecum and colon
Hookworm

(Necator americanus and Ancylostoma duodenale)

Skin penetration by filariform larvae No Attached to the mucosa of mid-upper portion of the small bowel
Strongyloides stercoralis Filariform larvae penetrate skin or bowel mucosa Yes
  • Lifetime of the host
Embedded in the mucosa of the duodenum, jejunum
Enterobius vermicularis

(pinworm)

Ingestion of infective ova Yes
  • 1-month
  • Extraintestinal migration is very rare[4]
Free air in the lumen of cecum, appendix, adjacent colon

References

  1. Puthiyakunnon S, Boddu S, Li Y, Zhou X, Wang C, Li J, Chen X (2014). "Strongyloidiasis--an insight into its global prevalence and management". PLoS Negl Trop Dis. 8 (8): e3018. doi:10.1371/journal.pntd.0003018. PMC 4133206. PMID 25121962.
  2. Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
  3. Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). "Chapter 39:Parasitic Infections". Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.
  4. Serpytis M, Seinin D (2012). "Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys". Scand J Urol Nephrol. 46 (1): 70–2. doi:10.3109/00365599.2011.609834. PMID 21879805.

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