Strongyloidiasis differential diagnosis: Difference between revisions

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==Differentiating Strongyloidiasis from other diseases==
==Differentiating Strongyloidiasis from other diseases==
The table below summarizes the findings that differentiate [[Strongyloidiasis]] from other [[Nematode|nematod]]<nowiki/>e infections:
The table below summarizes the findings that differentiate [[strongyloidiasis]] from other [[Nematode|nematod]]<nowiki/>e infections:
{| class="wikitable"
{| class="wikitable"
! colspan="8" |Differentiating strongyloidiasis 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><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>
! colspan="8" |Differentiating strongyloidiasis 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><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>
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|No
|No
|
|
* 3-5 years ([[Necator americanus|Necator]])
* 3-5 years (''[[Necator americanus|Necator]]'')
* 1 year ([[Ancylostoma]])
* 1 year (''[[Ancylostoma]]'')
|
|
* [[Löffler's syndrome]]
* [[Löffler's syndrome]]
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|}
|}
*Strongyloidiasis, when it involves the [[gastrointestinal tract]], presents with [[abdominal pain]] and must be differentiated from other [[Gastrointestinal tract|GI]] disorders like [[Peptic ulcer|peptic ulcer disease]], [[intussusception]], and [[Gall stones|bile duct stone]].
*Strongyloidiasis, when it involves the [[gastrointestinal tract]], presents with [[abdominal pain]] and must be differentiated from other [[Gastrointestinal tract|GI]] disorders like [[Peptic ulcer|peptic ulcer disease]], [[intussusception]], and [[Gall stones|bile duct stone]].
*The table below summarizes the findings that differentiate Strongyloidiasis from [[peptic ulcer disease]], [[intussusception]], and [[Gall stones|bile duct stone]]:
*The table below summarizes the findings that differentiate strongyloidiasis from [[peptic ulcer disease]], [[intussusception]], and [[Gall stones|bile duct stone]]:
{| class="wikitable"
{| class="wikitable"
!Disease
!Disease
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|[[Peptic ulcer disease]]
|[[Peptic ulcer disease]]
|
|
* [[Abdominal pain]],
* [[Abdominal pain]]
* [[Bloating]] and abdominal fullness
* [[Bloating]] and abdominal fullness
* [[Nausea]], and lots of [[vomiting]]
* [[Nausea]], and lots of [[vomiting]]
* [[Loss of appetite]] and [[weight loss]];
* [[Loss of appetite]] and [[weight loss]]
* [[Hematemesis]]
* [[Hematemesis]]
|
|
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|
|
* Rapid [[Urease|urease testing]] positive
* Rapid [[Urease|urease testing]] positive
* [[Helicobacter pylori|H. pylori]] on histology
* ''[[Helicobacter pylori|H. pylori]]'' on histology
* Negative stool exam and serology  
* Negative stool exam and serology  
|-
|-
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* Ultrasound findings include the target and pseudokidney signs
* Ultrasound findings include the target and pseudokidney signs
|-
|-
|Bile duct stone
|[[Gall stone|Bile duct stone]]
|
|
* [[Abdominal pain|Acute abdominal pain]]
* [[Abdominal pain|Acute abdominal pain]]

Revision as of 14:28, 3 August 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 can mimic other worm infections like Ascaris lumbricoides, Trichuris trichiura, hookworm infections (Necator americanus and Ancylostoma duodenale), Enterobius vermicularis (pinworm) and gastrointestinal pathologies such as peptic ulcer disease, intussusception in children, and bile duct stone.[1][2][3]

Differentiating Strongyloidiasis from other diseases

The table below summarizes the findings that differentiate strongyloidiasis from other nematode infections:

Differentiating strongyloidiasis from other Nematode infections[1][2][4]
Infection Nematode Transmission Direct Person-Person Transmission Duration of Infection Pulmonary Manifestation Location of Adult worm(s) Treatment
Strongyloidiasis Strongyloides stercoralis Filariform larvae penetrate skin or bowel mucosa Yes
  • Lifetime of the host
Embedded in the mucosa of the duodenum and jejunum
Trichuriasis 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
Ascariasis Ascaris lumbricoides Ingestion of infective ova No 1-2 years Free air in the lumen of the small bowel

(primarily jejunum)

Hookworm infection Necator americanus and Ancylostoma duodenale Skin penetration by filariform larvae No Attached to the mucosa of mid-upper portion of the small bowel
Enterobiasis 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
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)
Intussusception
  • Currant jelly stools
  • Most cases occur in children ages 6 months - 2 years
  • Ultrasound findings include the target and pseudokidney signs
Bile duct stone
  • 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. 1.0 1.1 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.
  2. 2.0 2.1 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.
  3. 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.
  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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