title: Imported strongyloidiasis in Spain.
abstract: OBJECTIVE
  The objective of this study was to assess the epidemiological, laboratory, and clinical features of imported strongyloidiasis in a tropical medicine referral unit in Madrid, Spain.
  
  
  METHODS
  This was a retrospective study based on a review of medical records. A patient was diagnosed with strongyloidiasis when the infection could be detected by conventional stool analysis and/or serology against Strongyloides stercoralis, regardless of the presence of symptoms.
  
  
  RESULTS
  One hundred and seventy-eight cases of strongyloidiasis were included in the study. Stool tests were performed in all patients, and serology in 160 patients (89.9%). The diagnosis of strongyloidiasis was based on serology only in four patients; 21 patients only had positive stool tests. A third of the total strongyloidiasis cases in this study were travel-related, mainly associated with short trips (<2 months). Only 47.8% of total cases were symptomatic. We found no differences in clinical presentation between immigrants and travelers with strongyloidiasis.
  
  
  CONCLUSIONS
  Not only should strongyloidiasis be suspected in symptomatic travelers and immigrants, but it should also be ruled out when elevated IgE levels or eosinophilia are present. Strongyloidiasis can be asymptomatic in HIV patients, but it should be diagnosed and treated before a possible hyperinfection develops.
authors.affiliation: Unit of Tropical Medicine, Infectious Disease Department, Hospital Carlos III, Madrid, Spain. Electronic address: germanro.76@gmail.com.
authors.forename: Germán
authors.initials: G
authors.lastname: Ramírez-Olivencia
authors.affiliation: Service of Internal Medicine, Hospital Clinico, Madrid, Spain.
authors.forename: Miguel Ángel Cuesta
authors.initials: MÁ
authors.lastname: Espinosa
authors.affiliation: Service of Internal Medicine, Hospital Clinico, Madrid, Spain.
authors.forename: Ana Bravo
authors.initials: AB
authors.lastname: Martín
authors.affiliation: Microbiology and Parasitology Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Nuria Iglesias
authors.initials: NI
authors.lastname: Núñez
authors.affiliation: Malaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Esperanza Rodríguez
authors.initials: ER
authors.lastname: de Las Parras
authors.affiliation: Unit of Tropical Medicine, Infectious Disease Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Mar Lago
authors.initials: ML
authors.lastname: Núñez
authors.affiliation: Unit of Tropical Medicine, Infectious Disease Department, Hospital Carlos III, Madrid, Spain.
authors.forename: Sabino Puente
authors.initials: SP
authors.lastname: Puente
mesh_terms: D000328:Adult; D000818:Animals; D058070:Asymptomatic Diseases; D004641:Emigration and Immigration; D004802:Eosinophilia / Q000473:pathology; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D017171:Strongyloides stercoralis / Q000302:isolation & purification; D013322:Strongyloidiasis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology*; D014195:Travel
chemical_list: D007073:Immunoglobulin E
keywords: HIV; Helminth; Strongyloides; Travel