Biomimetic Materials in Dentistry

Abstract

INTRODUCTION Strongyloidiasis, a soil-transmitted helminthiasis, may persist in the host for indefinite time.Most infected individuals are asymptomatic showing only unexplained eosinophilia or hyperimmunoglobulin E (IgE). In case of immunosuppression, strongyloidiasis may become a disseminated life-threatening disease. The aim of this study is to describe 187 cases of strongyloidiasis diagnosed by detection of the parasite in faeces. METHODS AND MATERIAL A retrospective review of Strongyloides stercoralis cases registered at laboratory of Microbiology from January 2008 to December 2013. Diagnosis was defined as the detection of larvae by formalin-ether concentration technique and/or by charcoal culture. Patients were classified as immigrants, travellers and visiting friends and relatives (VFR). Eosinophilia was considered when eosinophil count was >500/mul or eosinophil percentage >7% in peripheral blood and hyper-IgE if level of IgE >500U/ml. RESULTS One hundred eighty seven patients were included; men were 58.3%, with a mean age of 33 years (range: 6-73). Immigrants were 59.4%, VFR 39.6%, and two travellers. Areas of origin: Latin America 61.5%, Sub-Saharan Africa 31.0% and Asia 7.5%. Main countries: Bolivia 45.5%, Equatorial Guinea 15.5% and Ecuador 8.6%. Mean length of stay in Spain was 47 months (range: 0-290), mean length of trip for VFRs was 32 days (range: 14-2588). Main reasons for consultation were: eosinophilia 31.0% (57/184) of cases, screening 25.5%, screening for Chagas disease 23.4% and gastrointestinal symptoms 10.3% of cases. All patients were immunocompetents. Diagnosis was achieved by stool exam in 84.5% of cases and the rest of them by charcoal culture (15.5%). Absolute eosinophilia was present in 81.7%, absolute eosinophil mean count was 1244 (range: 124-11 602); eosinophils percentage >7% was present in 91.5% of cases and mean percentage of eosinophils was 15.4% (range: 2.8-44.9). Hyper-IgE was present in 76.5% (104/136) of cases, IgE mean was 1875 U/ml (range: 10- 14 663). CONCLUSIONS Strongyloidiasis is a common helminthic infection in immigrants, regardless of the length of stay in the host country, especially if eosinophilia or hyper-IgE is present. In case of strongyloidiasis eosinophils percentage count seems to be more reliable than absolute count or hyper-IgE. In this series charcoal culture of faeces improved diagnostic sensitivity.