agar and Intestinal-Diseases--Parasitic

Strongyloidiasis, caused by Strongyloides stercoralis, is diagnosis considered as a challenge to clinician and laboratory technician. Because the auto-infective larvae are difficult to eradicate, one regimen dose may be in-sufficient and re-treatment of patients on two occasions, at 1 and 2 months after the initial treatment dose was recommended. This re-treatment regimen has yet to be proven in clinical trials. This study was performed on 24 patients who completed the study and having Strongyloides larvae in their stool obtained from Mansoura University Hospitals. Each stool sample was examined by direct saline smear, the formalin-ether sedimentation technique and agar plate culture. Patients were treated with Mirazid double course for a month to be followed up by stool examination by traditional method and agar plate culture for three consecutive months. In this study five cases out of 24 were asymptomatic (20.8%). Symptoms include abdominal manifestations as nausea and vomiting (16.7%), epi-gastric pain and nausea (12.5%), generalized abdominal pain (12.5%), chronic diarrhea (16.7%), irregular bowel habit (8.3%), and urticaria with abdominal pain (4.2%). Agar plate culture gave 100% positivity, even in cases were negative by coprological methods either direct smear and/or sedimenttation technique. All cases were cured by Mirazid given for one month except three resistant cases. Only one case responded to repeated course of Mirazid, while the other two cases still had larvae in their stool by agar culture plate. On combined therapy of both Mirazid and Mebendazole, larvae could be eliminated from their stool as approved by agar plate culture.

Topics: Adolescent; Adult; Agar; Aged; Animals; Anthelmintics; Drug Resistance; Feces; Humans; Intestinal Diseases, Parasitic; Male; Middle Aged; Parasite Egg Count; Strongyloides stercoralis; Strongyloidiasis; Treatment Outcome

The quantitative formalin ethyl acetate concentration technique (QFEC) was compared to agar plate culture (APC) for the detection of Strongyloides stercoralis larvae. QFEC could substitute for APC only when the parasite load was higher than 50 larvae per g of stool. This study serves as a good reminder to those conducting stool exams about the sensitivity and specificity limitations of both techniques.

Topics: Acetates; Agar; Animals; Centrifugation; Feces; Formaldehyde; Humans; Intestinal Diseases, Parasitic; Larva; Parasitology; Strongyloides stercoralis; Strongyloidiasis

Human immunodeficiency virus (HIV) and intestinal parasites are common in Brazil. Previous studies have shown that infection with Strongyloides stercoralis is frequently associated with HIV infection. Strongyloidiasis is difficult to diagnosis and stool examination with conventional techniques fails to detect the helminth larvae. We made a prospective study, to test the efficacy of the agar plate technique to detect S. stercoralis in 211 HIV-positive patients and 213 HIV-negative patients in the city of Itajaí, Brazil, between September 2001 and June 2002. The feces samples of these patients were processed and analyzed according to the following methods: Lutz, formalin ethyl acetate, Baermann, Harada-Mori and agar plate culture. HIV-positive patients were more frequently infected by S. stercoralis (odds ratio= 5,.687). Among the methods used on fecal specimens, the larvae of S. stercoralis were most efficiently detected by the agar plate (69.7%) method, followed by the Baermann and the formalin ethyl acetate methods (48.5%) (P=0.01), Lutz (42.4%) (P=0.01), and Harada-Mori culture (24%) (P=0.001). Therefore agar plate culture is the most efficient method for the detection of S. stercoralis larvae and this technique should be the test of choice, especially in immunocompromised patients.

Topics: Adolescent; Adult; Agar; Animals; Culture Media; Feces; Female; HIV Infections; Humans; Intestinal Diseases, Parasitic; Male; Parasite Egg Count; Prospective Studies; Sensitivity and Specificity; Strongyloides stercoralis; Strongyloidiasis

An agar plate method for the diagnosis of intestinal strongyloidiasis was compared to the standard formalin-ethyl acetate concentration method. A total of 13 of 225 patients with eosinophilia had positive stools for strongyloides larva by agar plate compared to six of 225 by the formalin-ethyl acetate method (P = .0455). Nine positive stool specimens by the agar plate method were tested by the Baermann technique, and five were positive. The agar plate method is a sensitive and efficient technique for the diagnosis of strongyloidiasis.

Topics: Acetates; Agar; Animals; Feces; Formaldehyde; Humans; Intestinal Diseases, Parasitic; Parasitology; Strongyloides stercoralis; Strongyloidiasis