Page 489 - Review of Medical Microbiology and Immunology ( PDFDrive )

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PART VI Parasitology

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FIGURE 56–10
Necator and Strongyloides—filariform larvae. Filariform larva of Necator on the left and Strongyloides on the right. Filari-
form larva is the infective form that penetrates the skin. (Source: Public Health Image Library, Centers for Disease Control and Prevention.)

Epidemiology antibody to larval antigens is available through the Centers
for Disease Control and Prevention (CDC) in Atlanta.
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mebooksfree.com mebooksfree.com mebooksfree.com Ivermectin is the drug of choice. Albendazole is an alterna- mebooksfree.com
Strongyloidiasis occurs primarily in the tropics, especially
in Southeast Asia. Its geographic pattern is similar to that
Treatment
of hookworm because the same type of soil is required. In
the United States, Strongyloides is endemic in the southeast-
tive drug.
ern states.
Laboratory Diagnosis
Prevention
Prevention involves disposing of sewage properly and
Diagnosis depends on finding larvae, rather than eggs, in
the stool (see Figure 56–10). As with many nematode infec-
tions in which larvae migrate through tissue, eosinophilia
patients scheduled to received immunosuppressive drugs
(e.g., corticosteroids, TNF inhibitors) and who have lived
can be striking. Serologic tests are useful when the larvae
in an area of Strongyloides endemicity. serological tests to
are not visualized. An enzyme immunoassay that detects wearing shoes. To prevent Strongyloides hyperinfection in
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mebooksfree.com mebooksfree.com mebooksfree.com FIGURE 56–12 Necator and Ancylostoma (hookworms)—egg. mebooksfree.com

FIGURE 56–11
Arrow points to an egg of a hookworm. The eggs of Necator and
Ancylostoma duodenale—head of the adult
Ancylostoma are indistinguishable. Note the embryo coiled up
hookworm. Arrows point to the four cutting teeth in the mouth of
inside. (Source: Public Health Image Library, Centers for Disease Control and
Ancylostoma. (Source: Dr. M. Melvin, Public Health Image Library, Centers for
Disease Control and Prevention.)
Prevention.)

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