8/7/2019 Enterobiasis & Strongyloides

1/19

Enterobiasis&

Strongyloidiasis

Zawanah Zulkifli

0811520

8/7/2019 Enterobiasis & Strongyloides

2/19

Enterobiasis

8/7/2019 Enterobiasis & Strongyloides

3/19

Etiology Pinworm infection -Enterobius vermicularis

adult size, male= 2-15mm, female= 8-

13mm Gravid female = 15,000 eggs

Inhabit cecum, appendix, ileum & colon

Ingestion & inhalation

8/7/2019 Enterobiasis & Strongyloides

4/19

Epidemiology Commonest helminth

infection

Human-only known host 30% of children (5-14

years old)

Common in childrens

living, sleeping&playing area

Chronic parasitism due toautoinoculation with

habit of inserting their

8/7/2019 Enterobiasis & Strongyloides

5/19

Female migrate toperianal at night

Eggs embryonate =6hours (remainviable for 20days)

Enter human body(ingestion/anus)

larvae=duodenum

Adolescents=jejunum/ileum

Adult=caecum

Life cycle

8/7/2019 Enterobiasis & Strongyloides

6/19

Pathogenesis1)Mechanical stimulation & irritation2)Allergic reactions

3)Migration to anatomic sites pathogenic

8/7/2019 Enterobiasis & Strongyloides

7/19

Clinical manifestations

Asymptomatic Loss of appetite

Loss of sleep

Pruritus ani Pruritus vulvae

8/7/2019 Enterobiasis & Strongyloides

8/19

Diagnosis

History of nocturnal perianal pruritus

Confirmatory diagnosis - identification ofeggs/worms

Samples early morning, digital rectal, stool

8/7/2019 Enterobiasis & Strongyloides

9/19

Treatment Antihelmintic drugs

Mebendazole repeated in

2weeks Albendazole or pyrantel

pamoate

Others

8/7/2019 Enterobiasis & Strongyloides

10/19

Prevention

8/7/2019 Enterobiasis & Strongyloides

11/19

Strongyloidiasis

8/7/2019 Enterobiasis & Strongyloides

12/19

Etiology Round worm infection = Strongyloides

stercoralis

Adult size, male: 2mm, female: 2-2.2mm Female = parthenogenesis

8/7/2019 Enterobiasis & Strongyloides

13/19

Epidemiology in tropical & subtropical region

Poor sanitation & crowded living conditions

Dogs & cats = reservoirs

Hyperinfection syndrome = hematologicmalignancies, autoimmune diseases,malnutrition, drug-inducedimmunosuppression

8/7/2019 Enterobiasis & Strongyloides

14/19

Life cycle

8/7/2019 Enterobiasis & Strongyloides

15/19

Pathogenesis

8/7/2019 Enterobiasis & Strongyloides

16/19

Clinical manifestations

&

8/7/2019 Enterobiasis & Strongyloides

17/19

Diagnosis Fecal examination

Direct smear

Concentration method(formaldehyde ether)

Duodenal fluid examination

Enteric string test (Entero-

test) Aspiration via endoscopy

Sputum examination

Enzyme-linked

immunosorbent assay

8/7/2019 Enterobiasis & Strongyloides

18/19

Treatment Ivermectin (PO 200 / / )g k g d a y ( / /Th iab en d azole PO 2 5 m g kg d ose bid

- )2days

8/7/2019 Enterobiasis & Strongyloides

19/19

Prevention