Strongyloidiasis differential diagnosis: Difference between revisions

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==Overview==
==Overview==
[[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>
[[Strongyloidiasis]] must be differentiated from other nematode infections, [[Gastrointestinal bleeding|gastrointestinal]] [[Pathology|pathologies]] such as [[peptic ulcer disease]], [[intussusception]], 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==

Revision as of 17:56, 24 July 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] Furqan M M. M.B.B.S[3]

Overview

Strongyloidiasis must be differentiated from other nematode infections, gastrointestinal pathologies such as peptic ulcer disease, intussusception, 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 Strongyloidiasis from other Nematode infections[2][3][4]
Nematode Transmission Direct Person-Person Transmission Duration of Infection Pulmonary Manifestation Location of Adult worm(s) Treatment
Strongyloides stercoralis Filariform larvae penetrate skin or bowel mucosa Yes
  • Lifetime of the host
Embedded in the mucosa of the duodenum, jejunum
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
Enterobius vermicularis

(pinworm)

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

Other conditions that need to be differentiated from strongyloidies in fection include

Disease Common findings Differentiating features Laboratory findings
Peptic ulcer disease
  • Epigastric with severity relating to mealtimes
  • Waterbrash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus)
  • Rapid urease testing positive
  • H. pylori on histology
  • Negative stool exam and serology
Intussusception
  • Abdominal pain that is colicky and intermittent
  • Currant jelly stools
  • Most cases occur in children ages 6 months - 2 years
  • Ultrasound findings include the target and pseudokidney signs
Bile duct stone
  • Acute abdominal pain
  • Nausea and vomiting
  • Pain is usually located in the upper right abdominal area radiates to shoulders.
  • Jaundice.
  • Bilirubin
  • Abnormal liver function tests
  • Elevation of pancreatic enzymes

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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