Parasites, Hosts and Diseases

"Strongyloides"

Case Reports

Strongyloidiasis in a Diabetic Patient Accompanied by Gastrointestinal Stromal Tumor: Cause of Eosinophilia Unresponsive to Steroid Therapy: Eun Jeong Won, Jin Jeon, Young-Il Koh, Dong Wook Ryang; Korean J Parasitol 2015;53(2):223-226.
Published online April 22, 2015; DOI: https://doi.org/10.3347/kjp.2015.53.2.223

Abstract
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We report here a case of strongyloidiasis in a 72-year-old diabetic patient (woman) accompanied by gastrointestinal stromal tumor receiving imatinib therapy, first diagnosed as hypereosinophilic syndrome and treated with steroids for uncontrolled eosinophilia. She suffered from lower back pain and intermittent abdominal discomfort with nausea and diagnosed with gastrointestinal stromal tumor. After post-operative imatinib treatment eosinophilia persisted, so that steroid therapy was started under an impression of hypereosinophilic syndrome. In spite of 6 months steroid therapy, eosinophilia persisted. Stool examination was performed to rule out intestinal helminth infections. Rhabditoid larvae of Strongyloides stercoralis were detected and the patient was diagnosed as strongyloidiasis. This diagnosis was confirmed again by PCR. The patient was treated with albendazole for 14 days and her abdominal pain and diarrhea improved. This case highlights the need for thorough investigation, including molecular approaches, to test for strongyloidiasis before and during steroid therapies.

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Global prevalence and correlation of intestinal parasitic infections in patients with colorectal cancer: a systematic review and meta-analysis
Maryam Hataminejad, Bahareh Basirpour, Melika Baharlou, Masoumeh Gholami Koohestan, Hajar Ziaei Hezarjaribi, Bahman Rahimi Esboei, Shirzad Gholami, Seyed Abdollah Hosseini, Reza Saberi
BMC Gastroenterology.2025;[Epub] CrossRef
A case of disseminated strongyloidiasis diagnosed by worms in the urinary sediment
Young-Ha Lee
Parasites, Hosts and Diseases.2024; 62(2): 238. CrossRef
From past to present: opportunities and trends in the molecular detection and diagnosis of Strongyloides stercoralis
Abigail Hui En Chan, Urusa Thaenkham
Parasites & Vectors.2023;[Epub] CrossRef
Seropositivity Rates of Strongyloides stercoralis Antibody in the Southeastern Region of Republic of Korea: A Single-Center Retrospective Study
Taehwa Kim, Seungjin Lim
The Korean Journal of Parasitology.2022; 60(3): 181. CrossRef
Importance of detection of Strongyloides stercoralis DNA in fecal samples from patients with type 2 diabetes mellitus
Márcia Carolina Mazzaro, Émelin Alves dos Santos, Gessica Baptista de Melo, Priscila Duarte Marques, Laura Vilela Souza, Jefferson Elias-Oliveira, Bruna Campos da Silva, Ronaldo César Borges Gryschek, Fabiana Martins de Paula, Rosângela Maria Rodrigues
Clinics.2022; 77: 100060. CrossRef
Phylogenetic Positioning of a Strongyloides stercoralis Isolate Recovered from a Korean Patient and Comparison with Other Asian Isolates
Jaeho Bae, Mi Jin Jeong, Dong hoon Shin, Hyun Woo Kim, Sung Ho Ahn, Jun Ho Choi, Hak Sun Yu
The Korean Journal of Parasitology.2020; 58(6): 689. CrossRef
Report of the Korean Association of External Quality Assessment Service on Clinical Parasitology (2018–2019)
Suhak Jeon, Eun Jeong Won, Yu Jeong Lee, Moon-Ju Kim, Myung Geun Shin, Jong Hee Shin
Journal of Laboratory Medicine and Quality Assurance.2020; 42(4): 177. CrossRef
Strongyloides stercoralis infection in a patient with rheumatoid arthritis and type 2 diabetes mellitus: a case-based review
Alireza Ashiri, Molouk Beiromvand, Abdollah Khanzadeh
Clinical Rheumatology.2019; 38(11): 3093. CrossRef
Strongyloidiasis Current Status with Emphasis in Diagnosis and Drug Research
Tiago Mendes, Karen Minori, Marlene Ueta, Danilo Ciccone Miguel, Silmara Marques Allegretti
Journal of Parasitology Research.2017; 2017: 1. CrossRef

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Comorbid Gastric Adenocarcinoma and Gastric and Duodenal Strongyloides stercoralis Infection: A Case Report: An Na Seo, Youn-Kyoung Goo, Dong-Il Chung, Yeonchul Hong, Ohkyoung Kwon, Han-Ik Bae; Korean J Parasitol 2015;53(1):95-99.
Published online February 27, 2015; DOI: https://doi.org/10.3347/kjp.2015.53.1.95

Abstract
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Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient’s fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.

Citations

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Mariam T. El Khadrawe, Nahla El Skhawy, Maha M. Eissa
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NEOPLASIA AND PROLIFERATIVE LESIONS IN FREE-RANGING MOUNTAIN AND GRAUER'S GORILLAS (GORILLA BERINGEI)
Maya L. Iyer, Kirsten V. Gilardi, Michael R. Cranfield, Sarah M. Corner, Eddy Kambale Syaluha, Jean Bosco Noheri, Benard Ssebide, Jean Felix Kinani, Fred Nizeyimana, Ricky Okwir Okello, Julius Nziza, Martin Kabuyaya, Methode Bahizi, Richard Muvunyi, Elisa
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Gastroduodenal Strongyloidiasis Diagnosed during Iron Deficiency Anemia Workup
Malek Kreidieh, Neville Mobarakai, Sherif Andrawes, Robert Colef, Lara Kreidieh, Hassan Al Moussawi, Jean M. Chalhoub
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Ahmed Salih Alshewered
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A case of disseminated strongyloidiasis diagnosed by worms in the urinary sediment
Young-Ha Lee
Parasites, Hosts and Diseases.2024; 62(2): 238. CrossRef
Mining parasites for their potential as novel therapeutic agents against cancer
Neha Sylvia Walter, Shalmoli Bhattacharyya
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Association between Some Helminths and Tumorigenesis through Immunological and Biochemical Factors
Maryam Fasihi-Karami, Reza Afrisham, Saina Karami, Ehsan Beigzadeh, Forough Kazemi
Current Cancer Therapy Reviews.2023; 19(2): 96. CrossRef
STRONGYLOIDES STERCORALIS: A RARE CASE DIAGNOSED WITH ESOPHAGEAL SWAB SAMPLE
Arzu Hazal AYDIN, Buse BAYAZIT GÖZÜKÜÇÜK, Nesrin TURHAN
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi.2023; 25(1): 166. CrossRef
Is Gastric Involvement by Strongyloides stercoralis in an Immunocompetent Patient a Common Finding? A Case Report and Review of the Literature
Irene Pecorella, Tom Richard Okello, Gaia Ciardi, David Martin Ogwang
Acta Parasitologica.2022; 67(1): 94. CrossRef
Seropositivity Rates of Strongyloides stercoralis Antibody in the Southeastern Region of Republic of Korea: A Single-Center Retrospective Study
Taehwa Kim, Seungjin Lim
The Korean Journal of Parasitology.2022; 60(3): 181. CrossRef
Strongyloides Hyperinfection Causing Gastrointestinal Bleeding and Bacteremia in an Immunocompromised Patient
Juan Carlos De la Cruz Mayhua, Bisharah Rizvi
Cureus.2021;[Epub] CrossRef
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Janneke W. Duijster, Eelco Franz, Jacques Neefjes, Lapo Mughini-Gras
Frontiers in Microbiology.2021;[Epub] CrossRef
Colorectal Cancer Related to Chronic Strongyloides stercoralis Infection
M. Sava, T. Huynh, A. Frugoli, L. Kong, M. Salehpour, B. Barrows
Case Reports in Gastrointestinal Medicine.2020; 2020: 1. CrossRef
Phylogenetic Positioning of a Strongyloides stercoralis Isolate Recovered from a Korean Patient and Comparison with Other Asian Isolates
Jaeho Bae, Mi Jin Jeong, Dong hoon Shin, Hyun Woo Kim, Sung Ho Ahn, Jun Ho Choi, Hak Sun Yu
The Korean Journal of Parasitology.2020; 58(6): 689. CrossRef
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Hoang van Tong, Paul J. Brindley, Christian G. Meyer, Thirumalaisamy P. Velavan
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Gastric Strongyloidiasis: Report of 2 Cases and Brief Review of the Literature
Rawia Mohamed, Mowafak M. Hamodat, Mousa A. Al-Abbadi
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Strongyloidiasis Current Status with Emphasis in Diagnosis and Drug Research
Tiago Mendes, Karen Minori, Marlene Ueta, Danilo Ciccone Miguel, Silmara Marques Allegretti
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A case of adenocarcinoma developed in the small intestine with chronic strongyloidiasis
Satoshi Ishikawa, Tamaki Maeda, Kimiaki Hattori, Takahiro Watanabe, Takanori Kuramoto, Saori Ueno, Goro Ueno, Tadahiro Yamada, Akifumi Kanazawa, Masahiro Sakaguchi, Yoshitane Tsukamoto
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Carmine Catalano, Joshua Aron, Raghav Bansal, Anatoly Leytin
ACG Case Reports Journal.2017; 4(1): e104. CrossRef
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Claudia Machicado, Luis A. Marcos
International Journal of Cancer.2016; 138(12): 2915. CrossRef

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Strongyloides myopotami (Secernentea: Strongyloididae) from the Intestine of Feral Nutrias (Myocastor coypus) in Korea: Seongjun Choe, Dongmin Lee, Hansol Park, Mihyeon Oh, Hyeong-Kyu Jeon, Keeseon S. Eom; Korean J Parasitol 2014;52(5):531-535.
Published online October 22, 2014; DOI: https://doi.org/10.3347/kjp.2014.52.5.531

Abstract
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Surveys on helminthic fauna of the nutria, Myocastor coypus, have seldom been performed in the Republic of Korea. In the present study, we describe Strongyloides myopotami (Secernentea: Strongyloididae) recovered from the small intestine of feral nutrias. Total 10 adult nutrias were captured in a wetland area in Gimhae-si (City), Gyeongsangnam-do (Province) in April 2013. They were transported to our laboratory, euthanized with ether, and necropsied. About 1,300 nematode specimens were recovered from 10 nutrias, and some of them were morphologically observed by light and scanning electron microscopies. They were 3.7-4.7 (4.0±0.36) mm in length, 0.03-0.04 (0.033) mm in width. The worm dimension and other morphological characters, including prominent lips of the vulva, blunted conical tail, straight type of the ovary, and 8-chambered stoma, were all consistent with S. myopotami. This nematode fauna is reported for the first time in Korea.

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Hyo-Seok Kim, Joo-Yeon Kong, Jong-Hyun Kim, Seong-Chan Yeon, Il-Hwa Hong
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Journal of Veterinary Medical Science.2016; 78(12): 1887. CrossRef

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Brief Communication

Modified Formalin-Ether Concentration Technique for Diagnosis of Human Strongyloidiasis: Witthaya Anamnart, Pewpan M. Intapan, Wanchai Maleewong; Korean J Parasitol 2013;51(6):743-745.
Published online December 31, 2013; DOI: https://doi.org/10.3347/kjp.2013.51.6.743

Abstract
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We compared the efficacy and applicability of a modified formalin-ether concentration technique (M-FECT) to the conventional FECT (C-FECT) and the agar plate culture (APC) method for the detection of Strongyloides stercoralis larvae. For this purpose, we used 600 human fecal specimens collected in an endemic area of southern Thailand. In the M-FECT, we used 2 layers of wire meshes, instead of gauze, to avoid the loss by absorption/adhesion of larvae to the gauze during filtration, and we reduced the exposure time of S. stercoralis larvae in stool samples to formalin. By such simple modifications, the efficacy of M-FECT has become comparable to APC and was much better than that of C-FECT for the diagnosis of strongyloidiasis.

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Catherine A. Gordon, Jürg Utzinger, Stephen Muhi, Sören L. Becker, Jennifer Keiser, Virak Khieu, Darren J. Gray
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Wansiri Wiraphongthongchai, Paiboon Sithithaworn, Kavin Thinkhamrop, Kulwadee Suwannatrai, Kulthida Y. Kopolrat, Chanika Worasith, Apiporn T. Suwannatrai
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Original Article

A Cross-Sectional Study on Intestinal Parasitic Infections in Rural Communities, Northeast Thailand: Sirintip Boonjaraspinyo, Thidarut Boonmars, Butsara Kaewsamut, Nuttapon Ekobol, Porntip Laummaunwai, Ratchadawan Aukkanimart, Nadchanan Wonkchalee, Amornrat Juasook, Pranee Sriraj; Korean J Parasitol 2013;51(6):727-734.
Published online December 31, 2013; DOI: https://doi.org/10.3347/kjp.2013.51.6.727

Abstract
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Despite the existence of effective anthelmintics, parasitic infections remain a major public health problem in Southeast Asia, including Thailand. In rural communities, continuing infection is often reinforced by dietary habits that have a strong cultural basis and by poor personal hygiene and sanitation. This study presents a survey of the prevalence of intestinal parasitic infections among the people in rural Thailand. The community-based cross-sectional study was conducted in villages in Khon Kaen Province, northeastern Thailand, from March to August 2013. A total of 253 stool samples from 102 males and 140 females, aged 2-80 years, were prepared using formalin-ethyl acetate concentration methods and examined using light microscopy. Ninety-four individuals (37.2%) were infected with 1 or more parasite species. Presence of parasitic infection was significantly correlated with gender (P=0.001); nearly half of males in this survey (49.0%) were infected. Older people had a higher prevalence than younger members of the population. The most common parasite found was Opisthorchis viverrini (26.9%), followed by Strongyloides stercoralis (9.5%), Taenia spp. (1.6%), echinostomes (0.4%), and hookworms (0.4%). The prevalence of intestinal protozoa was Blastocystis hominis 1.6%, Entamoeba histolytica 0.8%, Entamoeba coli 0.8%, Balantidium coli 0.4%, Iodamoeba b?tschlii 0.4%, and Sarcocystis hominis 0.4%. Co-infections of various helminths and protozoa were present in 15.9% of the people. The present results show that the prevalence of parasitic infections in this region is still high. Proactive education about dietary habits, personal hygiene, and sanitation should be provided to the people in this community to reduce the prevalence of intestinal parasite infections. Moreover, development of policies and programs to control parasites is needed.

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Brief Communication

Molecular Identification of Oesophagostomum and Trichuris Eggs Isolated from Wild Japanese Macaques: Naoki Arizono, Minoru Yamada, Tatsuya Tegoshi, Kotaro Onishi; Korean J Parasitol 2012;50(3):253-257.
Published online August 13, 2012; DOI: https://doi.org/10.3347/kjp.2012.50.3.253

Abstract
PDF

Natural habitat fragmentation and reducing habitat quality have resulted in an increased appearance of Japanese macaques, Macaca fuscata (Gray, 1870), in suburban areas in Japan. To investigate the risk of zoonotic infections, a coprological survey of helminth eggs passed by wild Japanese macaques was carried out in 2009 and 2010 in Shiga Prefecture, Japan. Microscopic examination found helminth eggs in high prevalence, and nucleotide sequencing of DNA extracted from the eggs identified Oesophagostomum cf. aculeatum and Trichuris trichiura. A fecal culture also detected infective larvae of Strongyloides fuelleborni. These zoonotic nematodes pose a potential health issue to local people in areas frequented by Japanese macaques.

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Case Report

A Case of Fatal Strongyloidiasis in a Patient with Chronic Lymphocytic Leukemia and Molecular Characterization of the Isolate: Eshrat Beigom Kia, Hamid Reza Rahimi, Hossein Mirhendi, Mohammad Reza Nilforoushan, Ardeshir Talebi, Farzaneh Zahabiun, Hamid Kazemzadeh, Ahmad Reza Meamar; Korean J Parasitol 2008;46(4):261-263.
Published online December 20, 2008; DOI: https://doi.org/10.3347/kjp.2008.46.4.261

Abstract
PDF

Strongyloides stercoralis is a human intestinal parasite which may lead to complicated strongyloidiasis in immunocompromised. Here, a case of complicated strongyloidiasis in a patient with chronic lymphocytic leukemia is reported. Presence of numerous S. stercoralis larvae in feces and sputum confirmed the diagnosis of hyperinfection syndrome in this patient. Following recovery of filariform larvae from agar plate culture of the stool, the isolate was characterized for the ITS1 region of ribosomal DNA gene by nested-PCR and sequencing. Albendazole therapy did not have cure effects; and just at the beginning of taking ivermectin, the patient died. The most important clue to prevent such fatal consequences is early diagnosis and proper treatment.

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Brief Communication

Intestinal helminthiases and schistosomiasis among school children in an urban center and some rural communities in southwest Nigeria: Olufemi Moses Agbolade, Ndubuisi Chinweike Agu, Oluseyi Olusegun Adesanya, Adedayo Olugbenga Odejayi, Aliu Adekunle Adigun, Emmanuel Babatunde Adesanlu, Flourish George Ogunleye, Adetoun Omolayo Sodimu, Stella Ajoke Adeshina, Ganiyat Olusola Bisiriyu, Oluwatosin Ibiyemi Omotoso, Karen Mfon Udia; Korean J Parasitol 2007;45(3):233-238.
Published online September 20, 2007; DOI: https://doi.org/10.3347/kjp.2007.45.3.233

Abstract
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Intestinal helminths and schistosomiasis among school children were investigated in an urban and some rural communities of Ogun State, southwest Nigeria. Fecal samples of 1,059 subjects (524 males, 535 females) aged 3-18 years were examined using direct smear and brine concentration methods between June 2005 and November 2006. The pooled prevalence of infection was 66.2%. Ascaris lumbricoides showed the highest prevalence (53.4%) (P < 0.001) followed by hookworms (17.8%), Trichuris trichiura (10.4%), Taenia sp. (9.6%), Schistosoma mansoni (2.3%), Strongyloides stercoralis (0.7%), Schistosoma haematobium (0.6%), and Enterobius vermicularis (0.3%). The prevalences of A. lumbricoides, hookworms, Taenia sp., S. mansoni, and S. stercoralis in the urban centre were similar (P > 0.05) to those in the rural communities. The fertile and infertile egg ratios of A. lumbricoides in the urban centre and the rural communities were 13: 1 and 3.7: 1, respectively. Each helminth had similar prevalences among both genders (P > 0.05). The prevalence of A. lumbricoides increased significantly with age (P < 0.001). The commonest double infections were Ascaris and hookworms, while the commonest triple infections were Ascaris, hookworms, and Trichuris. The study demonstrates the need for urgent intervention programmes against intestinal helminthiases and schistosomiasis in the study area.

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Case Reports

A case of fatal hyperinfective strongyloidiasis with discovery of autoinfective filariform larvae in sputum: Jin Kim, Hyun-Soo Joo, Hyang-Mi Ko, Min-Sik Na, Sun-Ho Hwang, Jong-Cheol Im; Korean J Parasitol 2005;43(2):51-55.
Published online June 20, 2005; DOI: https://doi.org/10.3347/kjp.2005.43.2.51

Abstract
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The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 ± 21.2 ?m in length and 11 ± 0.6 ?m in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.

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A case of gastric strongyloidiasis in a Korean patient: Jin Kim, Hyun-Soo Joo, Doo-Hong Kim, Ho Lim, Yu-Ho Kang, Myung-Soo Kim; Korean J Parasitol 2003;41(1):63-67.
Published online March 20, 2003; DOI: https://doi.org/10.3347/kjp.2003.41.1.63

Abstract
PDF

A 69-year-old Korean man was admitted to emergency room with complaints of abdominal pain, vomiting, and diarrhea. Laboratory tests revealed eosinophilia, anemia, hypoproteinemia, and hyponatremia. The gastric mucosa showed whitish mottled and slightly elevated lesions on the body angle of antrum. Microscopically, chronic gastritis with incomplete intestinal metaplasia was observed. Many adult worms, larvae, and eggs in cross sections were located in the crypts. Furthermore, the filariform larvae of Strongyloides stercoralis with a notched tail were detected through the culture.

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Original Article

Persistent infection with Strongyloides venezuelensis in the Mongolian gerbil (Meriones unguiculatus): Byeong-Kirl Baek, In-Soo Whang, M. Khyrul Islam, Byeong-Soo Kim, Ibulaimu Kakoma; Korean J Parasitol 2002;40(4):181-186.
Published online December 30, 2002; DOI: https://doi.org/10.3347/kjp.2002.40.4.181

Abstract
PDF

To examine the fate of Strongyloides venezuelensis, Mongolian gerbils (Meriones unguicalatus) were orally infected with 1,000 L₃ larvae per animal. Altogether, 50 gerbils divided into 5 groups of 10 each were monitored for a period of 570 days to document the kinetics of faecal egg output, adults worm population, morphological development, fecundity, and hematological changes including peripheral blood eosinophilia. This study chronicled a life long parasitism of S. venezuelensis in the gerbil host, and showed that S. venezuelensis infection was quite stable throughout the course of infection and the worms maintained their normal development as evidenced by their body dimension. A progressive loss of body condition of the infected gerbils was observed as the level of infection advanced. However, no detectable pathological changes were observed in the gastrointestinal tract. The present findings indicate that an immunocompetent host, such as the Mongolian gerbil, can serve as a life long carrier model of S. venezuelensis if the worms are not expelled within 570 days after infection.

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