Maltreatment of Strongyloides infection: Case series and worldwide physicians-in-training survey

摘要: Abstract Background Strongyloidiasis infects hundreds of millions people worldwide and is an important cause mortality from intestinal helminth infection in developed countries. The persistence infection, increasing international travel, lack familiarity by health care providers, potential for iatrogenic hyperinfection all make strongyloidiasis emerging infection. Methods Two studies were performed. A retrospective chart review Strongyloides stercoralis cases identified through microbiology laboratory records 1993-2002 was conducted. Subsequently, 363 resident physicians 15 training programs queried with a case scenario strongyloidiasis, presenting immigrant wheezing eosinophilia. evaluation focused on recognition diagnostic recommendations. Results In 151 cases, stool ova parasite sensitivity poor (51%), eosinophilia (>5% or >400 cells/μL) commonly present (84%). Diagnosis averaged 56 months (intra-quartile range: 4-72 months) after immigration. Presenting complaints nonspecific, although 10% presented wheezing. Hyperinfection occurred 5 patients prescribed corticosteroids, 2 deaths. Treatment errors more often among providers unfamiliar (relative risk error: 8.4; 95% confidence interval, 3.4-21.0; P Conclusions US patients. Diagnostic consideration should occur appropriate exposure, nonspecific symptoms including wheezing, relative eosinophils/μL). residents’ knowledge limited places immigrants danger. Information about be included continuing medical education programs.