Iranian Journal of Parasitology 2014. 9(2):155-162.

An Analysis of Clinical Characteristics of Strongyloides stercoralis in 70 indigenous patients in Iran.
Meysam Sharifdini, Eshrat Beigom Kia, Keyhan Ashrafi, Mostafa Hosseini, Hossein Mirhendi, Mehdi Mohebali, Bahare Kamranrashani


Background: Clinical manifestations of Strongyloides stercoralis are variable from asymptomatic to hyperinfection and devastating disseminated infections. Hereby, clinical characteristics of a large series of Iranian strongyloidiasis indigenous cases are described.

Methods: The records of people referred to the Helminthological Diagnostic La-boratory of School of Public Health, Tehran University of Medical Sciences and School of Medicine, Gilan University of Medical Sciences, during 2009-2013 were reviewed. For those patients that were infected with S. stercoralis and their clinical manifestations and demographic data were available (70 cases) a checklist was pre-pared and data analyzed.

Results: Forty-three patients (61.4%) were male and 27 (38.6%) female. Gastroin-testinal, cutaneous and pulmonary symptoms were present in 71.4%, 25.7%, and 15.7% of patients, respectively. None of them had larva currens eruption. Eosino-philia was the most prevalent reason for suspicious on S. stercoralis, but the mean was lower in elderly patients. Hyperinfection were recorded in 8 patients (11.4%), and 2 cases had disseminated infection.

Conclusion: Eosinophilia is common both in asymptomatic and symptomatic cas-es of strongyloidiasis, but the mean tend to lower with increase in age.


Clinical characteristics; Eosinophilia; Hyperinfection; Strongyloides stercoralis

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Keiser PB, Nutman TB. Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev. 2004; 17(1):208-17.

Norsarwany M, Abdelrahman Z, Rahmah N, Ariffin N, Norsyahida A, Madihah B, Zeehaida M. Symptomatic chronic strongyloidiasis in children following treatment for solid organ malignancies: Case reports and literature review. Trop Biomed. 2012; 29(3):479-88.

Gonzalez A, Gallo M, Valls ME, Munoz J, Puyol L, Pinazo MJ, Mas J, Gascon J. Clinical and epidemiological features of 33 imported Strongyloides stercoralis infections. Trans R Soc Trop Med Hyg. 2010; 104(9):613-6.

Ashrafi K, Tahbaz A, Rahmati B. Strongyloides stercoralis: The most prevalent parasitic cause of eosinophilia in Gilan Province, northern Iran. Iran J Parasitol. 2010; 5(3):40-7.

Marcos LA, Terashima A, Canales M, Gotuzzo E. Update on strongyloidiasis in the imm-unocompromised host. Curr Infect Dis Rep. 2011;13(1):35-46.

Siddiqui AA, Berk SL. Diagnosis of Strongyloides stercoralis infection. Clin Infect Dis. 2001; 33(7):1040-7.

Igra-Siegman Y, Kapila R, Sen P, Kaminski ZC, Louria DB. Syndrome of hyperinfection with Strongyloides stercoralis. Rev Infect Dis. 1981; 3(3):397-407.

Kia EB, Mahmoudi M, Zahabiun F, Meamar AR. An evaluation on the efficacy of agar plate culture for detection of Strongyloides stercoralis. Iran J Parasitol. 2007; 2(1):29-34.

Shokri A, Sarasiabi KS, Teshnizi SH, Mahmoodi H. Prevalence of Strongyloides stercoralis and other intestinal parasitic infections among mentally retarded residents in central institution of southern Iran. Asian Pac J Trop Biomed. 2012; 2(2):88-91.

Nesheli HM, Moghaddam TG, Zahedpasha Y, Norouzi AR. Acute lymphoblastic leukemia with eosinophilia and Strongyloides stercoralis hyperinfection. Iran J Pediatr. 2011; 21(4):549-52.

Kia EB, Rahimi HR, Mirhendi H, Nilforoushan MR, Talebi A, Zahabiun F, Kazemzadeh H, Meamar AR. A case of fatal strongyloidiasis in a patient with chronic lymphocytic leukemia and molecular characterization of the isolate. Korean J Parasitol. 2008; 46(4):261-3.

Meamar AR, Rezaian M, Mohraz M, Hadighi R, Kia EB. Strongyloides stercoralis hyper-infection syndrome in HIV+/AIDS patients in Iran. Parasitol Res. 2007; 101(3):663-5.

Tabei SZ, Asadian F, Fakhar M, Safaei A. Gastrointestinal hyper infection due to Strongyloides stercoralis in a patient with behcet’s syndrome. Comp Clin Pathol. 2009; 18(1):89–91.

Moghaddassani H, Mirhendi H, Hosseini M, Rokni M, Mowlavi G, Kia E. Molecular diagnosis of Strongyloides stercoralis infection by PCR detection of specific DNA in human stool samples. Iran J Parasitol. 2011; 6(2):23-30.

Olsen A, van Lieshout L, Marti H, Polderman T, Polman K, Steinmann P, Stothard R, Thybo S, Verweij JJ, Magnussen P. Strongyloidiasis-the most neglected of the neglected tropical diseases? Trans R Soc Trop Med Hyg. 2009; 103(10):967-72.

Arfaa F. Medical helminthology. 7th ed. Tehran: Khosravi Press; 2010.

Rokni MB. The present status of human helminthic diseases in Iran. Ann Trop Med Parasitol. 2008; 102(4):283-95.

Chordia P, Christopher S, Abraham OC, Muliyil J, Kang G, Ajjampur S. Risk factors for acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in south India. Indian J Med Microbiol. 2011; 29(2):147-51.

Valerio L, Roure S, Fernandez-Rivas G, Basile L, Martinez-Cuevas O, Ballesteros AL, Ramos X, Sabria M. Strongyloides stercoralis, the hidden worm. Epidemiological and clinical characteris-tics of 70 cases diagnosed in the north metropolitan area of Barcelona, Spain, 2003-2012. Trans R Soc Trop Med Hyg. 2013; 107(8):465-70.

Genta RM, Gatti S, Linke MJ, Cevini C, Scaglia M. Endemic strongyloidiasis in northern Italy: Clinical and immunological aspects. Q J Med. 1988; 68(257):679-90.

Nuesch R, Zimmerli L, Stockli R, Gyr N, Christoph Hatz FR. Imported strongyloidosis: A longitudinal analysis of 31 cases. J Travel Med. 2005; 12(2):80-4.

Thomas B, Nutman MD. Evaluation and differential diagnosis of marked, persistent eosinophilia. Immunol Allergy Clin North Am. 2007; 27(3):529-49.

Gill GV, Welch E, Bailey JW, Bell DR, Beeching NJ. Chronic Strongyloides stercoralis infection in former British far east prisoners of war. QJM. 2004; 97(12):789-95.

Roman-Sanchez P, Pastor-Guzman A, Moreno-Guillen S, Igual-Adell R, Suner-Generoso S, Tornero-Estebanez C. High prevalence of Strongyloides stercoralis among farm workers on the mediterranean coast of Spain: Analysis of the predictive factors of infection in developed countries. Am J Trop Med Hyg. 2003; 69(3):336-40.

Loutfy MR, Wilson M, Keystone JS, Kain KC. Serology and eosinophil count in the diagnosis and management of strongyloidiasis in a non-endemic area. Am J Trop Med Hyg. 2002; 66(6):749-52.

Muennig P, Pallin D, Sell RL, Chan MS. The cost effectiveness of strategies for the treatment of intestinal parasites in immigrants. N Engl J Med. 1999; 340(10):773-9.

Safdar A, Malathum K, Rodriguez SJ, Husni R, Rolston KV. Strongyloidiasis in patients at a comprehensive cancer center in the United States. Cancer. 2004; 100(7):1531-6.


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