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Updated: May 22, 2026
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Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
Published on: August 22, 2012
Strongyloidiasis: a diagnosis more common than we think
Charles Philip Koczka1, Pierre Hindy, Adam Goodman
1Department of Gastroenterology and Hepatology, State University of New York, Health Science Center at Brooklyn, Brooklyn, New York, USA.
Summary
Strongyloides stercoralis infections, or strongyloidiasis, are increasingly seen in urban centers. Upper endoscopy with biopsy is recommended for diagnosis, even without eosinophilia, and co-infections with HIV and HTLV-1 should be considered.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Parasitology
Background:
- Strongyloides stercoralis is a neglected tropical helminth with under-recognized clinical significance in urban settings.
- Limited data exists on the presentation and diagnosis of strongyloidiasis in non-endemic urban medical centers.
Purpose of the Study:
- To describe the clinical characteristics, diagnostic methods, and outcomes of strongyloidiasis cases at an urban medical center.
- To evaluate the utility of different diagnostic approaches for Strongyloides stercoralis infection.
Main Methods:
- Retrospective case series of patients diagnosed with S. stercoralis infection from January 1998 to May 2011.
- Electronic medical record review using ICD-9 codes, analyzing demographics, symptoms, diagnostic methods, and treatment outcomes.
- International Classification of Diseases, 9th Revision codes were used for patient identification.
Main Results:
- Twenty-two cases of S. stercoralis infection were identified, with a mean age of 62.4 years; 14 patients were immigrants from the Caribbean.
- Common symptoms included diarrhea, abdominal pain, vomiting, and weight loss. Eosinophilia was present in 17 patients.
- Diagnosis was primarily via stool examination (19/22), but upper endoscopy with biopsy revealed gastritis and ulcers in symptomatic patients. Four patients were positive for human T-lymphotropic virus-1 (HTLV-1) and three for HIV.
Conclusions:
- Strongyloidiasis presents with gastrointestinal symptoms in urban populations, often in immigrants.
- Upper endoscopy with biopsy is a valuable diagnostic tool, especially when stool examinations are negative or inconclusive.
- Clinicians should consider testing for HIV and HTLV-1 in patients with strongyloidiasis, and not rely solely on eosinophilia for diagnosis.
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