Case Report
Copyright ©The Author(s) 2015.
World J Gastroenterol. Mar 21, 2015; 21(11): 3367-3375
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3367
Table 1 Results of blood tests
Blood testsLabs on first admissionDay 16 of illnessLabs on second admissionDay 22 of illness
Hemoglobin (g/dL)16.415.9
Hematocrit (%)48.346.0
Platelet count237000286000
White blood cell count1870023300
Differential count (%)
Blood urea nitrogen (mg/dL)1010
Creatinine (mg/dL)1.00.9
Albumin (g/dL)3.43.8
Alanine aminotransferase2665
Aspartate aminotransferase (U/L)3139
Alkaline phosphatase144284
Total bilirubin (mg/dL)0.20.3
Table 2 Reported cases of acute pancreatitis associated with Strongyloides stercoralis
CaseAge (yr)/genderPlace of originPresentationEosinophil count(per mm3)Amylase(U/L)Lipase(U/L)Diagnostic methodTreatmentRef.
144/FWest Indies (Caribbean)Abdominal pain Fever Pruritus210Not providedNot providedExamination of biliary fluid obtained through percutaneous biliary drainThiabendazoleDelarocque Astagneau et al[14], 1994
245/FEcuadorAbdominal pain Nausea Vomiting9002591574Endoscopic duodenal biopsy Stool examinationAlbendazole Thiabendazole IvermectinNúñez et al[15], 2003
381/FKentucky, USAAbdominal pain Nausea Vomiting12542100>2000Examination of biliary fluid obtained through ERCPAlbendazolePerez-Jorge et al[16], 2008
464/MPuerto RicoAbdominal pain Nausea Vomiting Dyspnea Confusion7764367>396Clinical history and stool examinationIvermectinJones et al[17], 2009
5 (our case)48/MDominican RepublicAbdominal pain10900263476Endoscopic duodenal biopsy and serologyIvermectinMakker et al, 2015
Table 3 Various diagnostic tests available for Strongyloides stercoralis
TestSensitivity and specificityRemarks
Stool smear30% sensitivity for single stool sample[35]Simple test but insensitive
Agar plate culture90% sensitivity[28]Sensitive and simple
But needs 2 d for results
Health hazard to lab workers
Serologic tests
IFATIFAT: 97% sensitivity and 98% specificity[29]Cross reactivity except with LIPS
ELISAELISA: 93% sensitivity and 95% specificity[30]Inability to differentiate past and current infection
LIPSLIPS: 97% sensitivity and 100% specificity[32]Expensive
Molecular tests
PCRPCR: 99%-100% sensitivity and 15%-100% specificity[34]Low specificity with low parasite burden
LAMPNot widely available
Table 4 Treatment of Strongyloidiasis
DrugDosePregnancy class
Ivermectin200 μg/kg of bodyweight orally repeated on two days consecutively or after 2 wkC
(preferred drug of treatment)
Albendazole400 mg orally two times a day for 3-7 dC
Hyperinfection syndrome and disseminated Strongyloides infection
200 μg/kg of bodyweight orally until stool and/or sputum tests are negative for two wk (duration of auto-infective cycle)