Article Figures & Tables
Figures
- Figure 1:
Life cycle of Strongyloides stercoralis.1
- Figure 2:
Prevalence of Strongyloides stercoralis infection by country.1
Tables
- Box 1: Selected infectious causes of travel-related high-grade eosinophilia and associated clinical features*,†
Disease or pathogen Geography Relevant exposure Incubation period Selected clinical manifestations‡ Laboratory diagnosis Ascariasis§ Worldwide Fecal–oral 3–9 d Löeffler syndrome with cough, dyspnea, wheeze, chest discomfort, fever; urticarial rash Stool O&P Hookworm§,¶ Worldwide Skin exposure to contaminated soil 8–21 d Löeffler syndrome with cough, dyspnea, wheeze, chest discomfort, fever; pruritic maculopapular eruption at site of larval penetration Stool O&P Paragonimiasis Tropics/subtropics** Ingesting undercooked crab or crayfish Several months Cough, chest pain, hemoptysis, rust-coloured sputum, urticarial rash Sputum/stool O&P, serologic testing Schistosomiasis Tropics/subtropics** Fresh water exposure 3–4 wk Often asymptomatic; Katayama fever with fever, urticaria and angioedema, chills, myalgia, arthralgia, dry cough, diarrhea, abdominal pain, headache Stool/urine O&P, serologic testing Strongyloidiasis§ Tropics/subtropics Skin exposure to fecally contaminated soil 23–32 d Löeffler syndrome with cough, dyspnea, wheeze, chest discomfort, fever; pruritic maculopapular eruption at site of larval penetration, larva currens; diarrhea Stool O&P, serologic testing†† Toxocariasis Worldwide Fecal–oral, ingesting undercooked organ meat Weeks or months Often asymptomatic; fever, hepatitis, pneumonitis, urticarial rash Serologic testing, tissue biopsy Trichinosis Worldwide Ingesting undercooked meat‡‡ 7–30 d Often asymptomatic; muscle pain tenderness and swelling, elevated creatine kinase, periorbital edema, conjunctival hemorrhages Serologic testing, muscle biopsy Note: O&P = ova and parasite.
* Data obtained from the article by Freedman3 and the Centers for Disease Control and Prevention (www.cdc.gov/dpdx/az.html).
† Other causes of travel-related high-grade peripheral blood eosinophilia include filariasis, gnathostomiasis and fascioliasis.
↵‡ Selected symptoms are listed; for ascariasis, hookworm and stronyloidiasis presenting in the context of Löeffler syndrome, only symptoms typical of that stage are listed.
↵§ High-grade eosinophilia seen during the migration phase of the parasite with symptomatic cases typically presenting with Löeffler syndrome.
↵¶ Species: Ancylostoma duodenale, Necator americanus.
↵** Species: Paragonimus westermani (found in Southeast Asia, Japan); other Paragonimus species found throughout the Americas, Africa and Southeast Asia. Schistosoma mansoni (found in Africa, South America, Caribbean); Schistosoma hematobium (found in Africa, parts of the Middle East); Schistosoma japonicum (found in Southeast Asia, including Indonesia, parts of China).
↵†† In the context of Löeffler syndrome, results from stool O&P testing are typically negative; for strongyloidiasis, the diagnosis is not fully excluded even in chronic infections by repeated negative results for stool O&P testing.
↵‡‡ Domestic pork or meat from wild game (including boar, bear, deer).
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