Abstract:
Strongyloidiasis is a helminth infection affecting 613.9 million people annually, mainly in the tropics and subtropics. The reported seroprevalence in the United States is 4% with most of the cases reported in immigrants. Human T-lympho-tropic virus 1 (HTLV-1) infections, hypogammaglobulinemia, immunosuppressant use - particularly steroid use, alcoholism, and malnutrition have been associated with an increased risk of strongyloidiasis. Recently, cases of strongyloidiasis hyperinfection syndrome have been described in coronavirus disease 2019 (COVID-19) patients treated with steroids as well. This brief review discusses the epidemiology, clinical features, management, and prevention of strongyloidiasis including some facts about the infection in pregnancy, transplant recipients, and COVID-19 patients. We conducted an online search using the PubMed, Scopus, and Google Scholar databases. Strongyloidiasis can be asymptomatic or present with mild symptoms. Strongyloides stercoralis is known to cause autoinfection. In immunocompromised individuals, it can present with severe symptoms, hyperinfection, or disseminated disease. Reported mortality in cases of disseminated Strongyloidiasis is 87.1%. Serology and detection of larvae in stool by direct microscopy are the most commonly used methods to diagnose strongyloidiasis. The drug of choice for the treatment is ivermectin. However, the use of ivermectin in human pregnancy is not well studied, and its teratogenic risks are unknown. Proactive screening of strongyloidiasis is necessary in immunocompromised individuals to prevent severe disease.
摘要:
Strongyiopiasis是一种蠕虫感染,每年影响6.139亿人,主要在热带和亚热带地区。在美国报告的血清阳性率为4%,大多数病例报告为移民。人类嗜T淋巴细胞病毒1(HTLV-1)感染,低球蛋白血症,免疫抑制剂的使用-特别是类固醇的使用,酗酒,营养不良与线虫病的风险增加有关。最近,在接受类固醇治疗的2019年冠状病毒病(COVID-19)患者中也描述了圆线虫病过度感染综合征的病例。这篇简短的综述讨论了流行病学,临床特征,管理,和预防线虫病,包括一些有关怀孕感染的事实,移植接受者,和COVID-19患者。我们使用PubMed进行了在线搜索,Scopus,和谷歌学者数据库。网状线虫病可以无症状或表现为轻度症状。已知侧圆圆线虫会引起自身感染。在免疫受损的个体中,它可以表现出严重的症状,过度感染,或传播疾病。报告的播散性流圆线虫病死亡率为87.1%。血清学和直接显微镜检测粪便中的幼虫是最常用的诊断方法。用于治疗的选择药物是伊维菌素。然而,伊维菌素在人类怀孕中的使用还没有得到很好的研究,其致畸风险未知。在免疫功能低下的个体中,有必要对圆线虫病进行积极的筛查,以预防严重的疾病。