Small bowel (small intestine) - Strongyloides stercoralis

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Small bowel (small intestine)

Infectious disorders

Strongyloides stercoralis

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 20 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Nematode with complex life cycle that alternates between free-living and parasitic cycles, with potential for autoinfection and multiplication within host

Life cyclel
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● Larvae burrow into mucosa of duodenum and jejunum, where they mature into adults
● Females lay eggs, which develop into larvae that pass into stool, where they mature and become infective
● Infective larvae in soil penetrate intact skin, usually through feet
● Larvae enter circulatory system, are transported to lungs, enter alveolar spaces, are carried to trachea and pharynx, are swallowed and enter intestinal tract, where process is repeated
● If larvae become infective before leaving body, they may invade intestinal mucosa or perianal skin, causing autoinfection

Life cycle

Clinical features
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● Symptoms: none, diarrhea, malabsorption
● Severe/fatal infections in immunocompromised, due to worms moving from GI tract into other organs (WormBook. 2007 May 23:1-15.)

Diagnosis
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● Larvae in stool
● Adult female or eggs in small bowel mucosa, often with eosinophilic or granulomatous inflammation

Case reports
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● 43 year old Honduran man with diarrhea and abdominal pain (Case of the Week #133)
● 66 year old man with weakness and epigastric pain (Int J Prev Med 2012;3:370)

Treatment
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● Antihelminths such as thiabendazole (Ann Pharmacother 2007;41:1992)
● Prevent by wearing shoes in endemic areas

Micro images
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Case of the Week #133

Various images

Virtual slides
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Small intestine

Additional references
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● Arq Gastroenterol 2011;48:225

End of Small bowel (small intestine) > Infectious disorders > Strongyloides stercoralis

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