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Influence of parasite load on the diagnosis and occurrence of eosinophilia in alcoholic patients infected with Strongyloides stercoralis

Published online by Cambridge University Press:  28 November 2017

M.L.S. Silva ,
E.J. Inês ,
J.N. Souza ,
A.B.S. Souza ,
V.M.S. Dias ,
L.N. Oliveira ,
C.M. Guimarães ,
E.R. Menezes ,
L.G. Barbosa  and
M.C.M. Alves
...Show all authors
M.L.S. Silva
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
E.J. Inês
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
J.N. Souza
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
A.B.S. Souza
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
V.M.S. Dias
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
L.N. Oliveira
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
C.M. Guimarães
Affiliation:
Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil
E.R. Menezes
Affiliation:
Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil
L.G. Barbosa
Affiliation:
Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil
M.C.M. Alves
Affiliation:
Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil
M.C.A. Teixeira
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
N.M. Soares*
Affiliation:
Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
*
Author for correspondence: N.M. Soares, Fax: +55 71 32836919, E-mail: necisoares@gmail.com
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Abstract

Alcoholic patients are more susceptible to Strongyloides stercoralis infection. The chronic use of alcohol raises the levels of endogenous corticosteroids, which regulates the development of larvae and stimulates the differentiation of rhabditiform into infective filariform larvae, thus inducing internal autoinfection. Therefore, early diagnosis is important to prevent severe strongyloidiasis. The aim of this study was to evaluate the efficacy of parasitological methods, according to the parasite load and the number of stool samples, for diagnosis of S. stercoralis infection, as well the peripheral blood eosinophil count in alcoholic patients. A total of 330 patients were included in this study. The diagnosis was established using three parasitological methods: agar plate culture, Baermann–Moraes method and spontaneous sedimentation. Peripheral eosinophilia was considered when the level was >600 eosinophils/mm3. The agar plate culture (APC) had the highest sensitivity (97.3%). However, the analysis of multiple samples increased the sensitivity of all parasitological methods. The sensitivities of the methods were influenced by the parasite load. When the larval number was above 10, the sensitivity of APC was 100%, while in spontaneous sedimentation the sensitivity reached 100% when the larval number was above 50. In the present study, 15.4% of alcoholic patients infected with S. stercoralis (12/78) had increased peripheral blood eosinophil count (above 600 eosinophils/mm3). For an efficient parasitological diagnosis of S. stercoralis infection in alcoholic patients, repeated examination by two parasitological methods must be recommended, including agar plate culture due to its higher sensitivity. Moreover, S. stercoralis infection was associated with eosinophilia, mostly in patients excreting up to 10 larvae/g faeces.

Type
Research Paper
Information
Journal of Helminthology , Volume 93 , Issue 1 , January 2019 , pp. 21 - 25
Copyright
Copyright © Cambridge University Press 2017 

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