Chronic strongyloidiasis in Tasmanian veterans--clinical diagnosis by the use of a screening index
Oliver, N.W.; Rowbottom, D.J.; Sexton, P.; Goldsmid, J.M.; Byard, R.; Tooth, M.; Thomson, K.S.
Australian and New Zealand Journal of Medicine 19(5): 458-462
1989
ISSN/ISBN: 0004-8291 PMID: 2590096 Document Number: 341129
Chronic infection with Strongyloides stercoralis presents a diagnostic problem because of the low recovery of the organism from stools and the insensitivity of current serological tests. Of 150 former Far East POWs, 26 (17%) had S. stercoralis in stools. The clinical features in 18 stool-positive patients were compared to those in 24 stool-negative patients and showed that strongyloidiasis was associated with a higher frequency of alteration in bowel habit, upper abdominal discomfort, rash and eosinophilia. On the basis of these features, a screening index was devised which largely separated stool-positive and stool-negative patients and led to helpful therapy in three of four patients with compatible symptoms who lacked a definitive diagnosis. Treatment with thiabendazole appeared to be superior to treatment with mebendazole.