Rare Case Report from Gram Stain of Sputum Showing Strongyloides: Introduction and Impression
Introduction of a rare case report from Gram stain of sputum
Before going to deal with a rare case report, let’s know about Strongyloides. Strongyloides stercoralis is a nematode parasite and its habitat is in the jejunum and rarely in the duodenum too. The suspected patient may have eosinophilia, dermatitis, hemoptysis, bronchopneumonia, asthma-like symptoms, malabsorption, symptoms like peptic ulcer, mucous diarrhea, dysentery. Diagnosis of this organism in the laboratory for demonstration of larvae specimens like stool, sputum, and gastric aspirate is useful, whereas other tests are stool culture, serological tests, complement fixation test(CFT), indirect haemagglutination test (IHT), ELISA, and condition of eosinophilia on PBS.
Strongyloides stercoralis picture under the gram-stained slide of sputum from a patient admitted in a medical ward with a history of anemia and hemodialysis also with self recovered diarrhea. No bacteria and fungal growth and only Strongyloides stercoralis was the causative agent. Specimen again requested for sputum and stool analysis- Strongyloides stercoralis saw on both specimens. The patient improved after taking albendazole orally.
Life cycle of Strongyloides stercoralis (brief)
Adult worm (female) in the intestine of man
Eggs laid in mucosa hatch immediately
Rhabditiform larva in stool in soil
Becomes free-living adult worm in soil
Infection in man by skin penetration ( generally feet)
Reaches jejunum ( filariform develops into adults i.e. male and female) and cycle repeats
It can reach lung and filariform larva in blood.
Impression for this a rare case report from Gram stain of sputum
While reporting gram stained slides, we always remember the nature of specimens and availability of organisms; and broaden our vision for report a variety of causative agents without missing them because as you know laboratory diagnosis is the third eye of clinicians that makes treatment easier as well as short hospital stay and reduce patient economic burden.
Further Readings
- Merkell and Voge’s medical parasitology
9th edition. - Parasitology: 12th edition
By K. D. Chatterjee - District laboratory practice in Tropical countries –Part-I.
By Monica Chesbrough. - Isenberg clinical microbiology procedures Handbook
2nd edition. Vol. 2 - Atlas of Medical Helminthology and protozoology -4th edn -P.L. Chiodini, A.H. Moody, D.W. Manser
- Medical Parasitology by Abhay R. Satoskar, Gary L. Simon, Peter J. Hotez and Moriya Tsuji
- Atlas of Human Parasitology, Lawrence R Ash, Thomas C. Orihel, 3 rd ed, Publisher ASCP Press, Chicago.
- Molecular Medical Parasitology. Editors: J. Joseph Marr, Timothy W. Nilsen and Richard W. Komuniecki, Publisher Academic Press, an imprint of Elsevier Science.
- Topley & Wilsons’ Principle of parasitology. Editors: M.T. Parker & L.H. Collier, 8 th ed 1990, Publisher Edward Arnold publication, London.