Strongyloidiasis - Symptoms.

The incubation period for strongyloidiasis has not been established.

There are acute (early migratory) and chronic stages of strongyloidiasis. In most infected individuals, the early migratory stage is asymptomatic. In manifest cases, the symptom complex of acute infectious-allergic disease prevails during this period of strongyloidiasis. In case of percutaneous infection, erythematous and maculopapular rashes accompanied by itching appear at the site of larval penetration. Patients complain of non-specific symptoms of strongyloidiasis: general weakness, irritability, dizziness and headache, increased body temperature (up to 38-39 °C). Symptoms of bronchitis or pneumonia are observed: cough, sometimes with blood in the sputum, shortness of breath, bronchospasm. X-rays reveal "flying" infiltrates in the lungs. These symptoms of strongyloidiasis last from 2-3 days to a week or more. 2-3 weeks after infection, most patients develop symptoms of gastrointestinal tract damage: dull or cramping abdominal pain, diarrhea alternating with constipation, loss of appetite, salivation, nausea, and vomiting. Liver and spleen may enlarge. Peripheral blood shows eosinophilia up to 30-60%, leukocytosis, and increased ESR. After 2-3 months, the described symptoms of strongyloidiasis subside and the disease becomes chronic, which is characterized by polymorphism of clinical manifestations with a predominance of gastrointestinal tract disorders (including duodeno-gall-bladder syndrome), functional disorders of the central nervous system and autonomic nervous system, and allergic symptoms.

The gastrointestinal form of strongyloidiasis is characterized by a long course with periodic exacerbations of symptoms of gastritis, enteritis, enterocolitis (heartburn, abdominal pain, flatulence, weight loss, anorexia, nausea, vomiting, diarrhea). With intense invasion, the mucosa ulcerates, and intestinal paresis may develop. In such cases, the disease proceeds as a duodenal ulcer, ulcerative colitis, or acute abdomen. Signs of biliary dyskinesia are often observed with this form of invasion.

The neuro-allergic form of strongyloidiasis occurs with asthenoneurotic syndrome, urticarial rash (linear, ring-shaped) with severe itching. In case of autosuperinvasion (with retention of larvae in perianal folds due to fecal contamination of the skin), which is more often observed in people with mental disorders and low sanitary culture, persistent dermatitis occurs in the perineum, on the buttocks, and inner thighs.

Possible damage to the respiratory system with the development of asthmatic bronchitis. In the mixed form of strongyloidiasis, all manifestations of the disease or some of them may be expressed.

In severe cases of strongyloidiasis, debilitating diarrhea with dehydration, malabsorption syndrome, anemia, and cachexia are observed. Serious symptoms of strongyloidiasis are possible: ulcerative lesions of the intestine, often ending in perforative peritonitis, parenchymatous liver dystrophy, and necrotic pancreatitis. In weakened patients, those who abuse alcohol, or have immunodeficiency (with AIDS, leukemia, radiation therapy, long-term use of glucocorticoids, cytostatics), an extremely unfavorable course of strongyloidiasis is observed, which turns into a hyperinvasive and disseminated form. Strongyloid hyperinvasion is caused by a high number of parasites and is characterized by the penetration of filariform larvae into many organs and tissues. Migration of larvae to the brain causes vascular thrombosis, edema, and rapid death of the patient. In disseminated strongyloidiasis, one of the characteristic laboratory signs, eosinophilia, is often absent. Strongyloidiasis is considered an AIDS-associated parasitic disease.

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Complications of strongyloidiasis

Strongyloidiasis can be complicated by the development of hyperinvasive syndrome with the severe symptoms listed above, even to the point of death.

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