3strongyloidiasis
DESCRIPTION
StrongyloidiasisTRANSCRIPT
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STRONGYLOIDIASISETIOLOGY: STRONGYLOIDES STERCORALIS
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PATHOGENESIS
ABILITY OF S. S. TO REPLICATE WITHIN THE HOST IN CHRONIC STRONGYLOIDIASIS:* BALANCE BETWEEN HOST PARASITE
WHERE WORMS RESTRICTED IN NUMBER
HOST DEFENSES BREAK DOWN
WORMS MULTIPLY RAPIDLY & DISSEMINATE THROUGHOUT THE BODY
CUTANEOUS LESION HYPERSENSITIVITY Rx WORMS PRODUCTS ENTERITIS:DIRECT MECHANICAL TRAUMAINFLAMMTORY RxSECONDARY BACTERIAL COLONIZATION
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CLINICAL MANIFESTATIONS (1)
ACUTE STRONGYIDIASIS
LARVAE THROUGHT THE LUNGSLOEFFLERS SYNDROM, COUGH, SHORTNESS OF BREATH, WHEEZING, FEVER, IN THE GUTABDOMINAL PAIN, DIARRHEA, EPIGASTRIC PAIN, MALABSORPSION
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CHRONIC STRONGYLOIDIASIS- S.S. INFECTIONS > 35 YEARS * ASYMPTOMATIC * CUTANEOUS SYMP. * GASTROINTESTINAL SYMP. - THE CLASSIC TRIAD: ABDOMINAL PAIN DIARRHEA URTICARIA - CREEPING ERUPTION CLINICAL MAAANIFESTATIONS (2)
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DISSEMINATED STRONGYLOIDIASIS (1) - OVERWHELMING STRONGYLOIDIASIS - IMMUNOSUPRESSED RESULT OF DISEASES - IMMUNOSUPRESSIVE AGENTS - MALNUTRITION - PATIENTS WITH BURN - CHRONIC INFECTION - IRRADIATION - LYMPHOMAS - AIDS - SYSTEMIC CORTICOSTEROID THERAPY
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DISSEMINATED STRONGYLOIDIASIS (2) - SEVERE, GENERALIZED ABDOMINAL PAIN - ABDOMINAL DISTENTION - SHOCK - ILEUS EDEMA SMALL-BOWEL OBSTRUCTION FATAL NECROTIZING JEJUNITIS - JAUNDICE
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- MASSIVE LARVAL INVATION OF THE LUNG: * COUGH * WHEEZING * DYSPNEA - CEREBRAL INVOLMENT: * CHANGE IN MENTAL STATUS * COMA - HIGH FEVER DISSEMINATED STRONGYLOIDIASIS (3)
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CLINICAL FINDINGS (1)1. CUTANEOUS MANIFESTATIONS - FOCAL EDEMA - INFLAMMATION - PETECHIAE - SERPIGIOUS OR URTICARIAL TRACT, AND INTENSE ICTHING - CREEPING ERUPTIONS CHRONIC
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2. INTESTINAL MANIFESTATIONS: MILD SEVERE - ANOREXIA - VOMITING - EPIGASTRIC TENDERNESS MIMIC DUODENAL ULCER - DIARRHEA DIARRGEA CONSTIPATION - ABDOMINAL PAIN - FLATULENCE - PRURITUS ANI - FECES CONTAIN MUCUS AND BLOOD - MALABSORPTION
CLINICAL FINDINGS (2)
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3. PULMONAL MANIFESTATIONS - DRY COUGH - THROAT IRRITATION OR LOW-GRADE FEVER - DYSPNEA - WHEEZING - HEMOPTYSIS - ASTHMA CLINICAL FINDINGS (3)
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CLINICAL FINDINGS (4) - BRONCHOPNEUMONIA - BRONCHITIS - PLEURAL EFFUSION - PROGRESSIVE DYSPNEA - MILIARY ABSCESSES - COUGH: * PRODUCTIVE OF AN ODORLESS * MUCOPURULENT SPUTUM
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COMPLICATION: HYPERINFECTION (1)
1. PLEURAL EFFUSION2. MYOCARDITIS3. HEPATIC GRANULOMAS4. CHOLECYSTITIS5. PURPURA6. ULCERATING LESIONS OF THE GI. TRACT7. CNS INVOLVEMENT
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COMPLICATION: HYPERINFECTION (2)
8. PARALYTIC ILEUS9. PERFORATION-PERITONITIS10. GRAM-NEGATIVE SEPTICEMIA11. MENINGITIS12. CACHEXIA13. SHOCK ABD DEATH14. NEPHROTIC SYNDROME
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MANAGEMENT (1)
* UNCOMPLICATED STRONGYLOIDIASIS- IVERMECTIN, 200 G/KG FOR 2 DAYS- THIABENDAZOLE, 25 MG/KGBW, TWICE DAYLY FOR 3 DAYS (MAX. 1,5 G PER DOSE), REPEAT IN 2 WEEKS- MEBENDAZOLE- CAMBENDAZOLE- ALBENDAZOLE, 2 X 400 MG FOR 3-7 DAYS, REPEATED IN 1 WEEK
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* DISSEMINATED STRONGYLOIDIASIS - THIABENDAZOLE, 25 MG/KGBWTWICE DAYLY FOR 1 WEEK - REPEATED 25 MG/KGBW TWICE DAYLY FOR 2 DAYS AT MONTHLY INTERVALS
MANAGEMENT (2)
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PRGONOSIS
PROGNOSIS IS FAVORABLE EXCEPT: * IN THE HYPERINFECTION * ASSOCITED WITH EMACIATON * ADVANCED LIVER DISEASE * CANCER * IMMUNOLOGIC DISORDERS * THE USE OFI MMUNOSUPPRESSIVE DRUGS