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2008, Número 2

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Rev Mex Patol Clin Med Lab 2008; 55 (2)


Strongyloides stercoralis: ciclo vital, cuadros clínicos, epidemiología, patología y terapéutica

Carrada-Bravo T

Idioma: Español
Referencias bibliográficas: 92
Paginas: 88-110
Archivo PDF: 566.45 Kb.


RESUMEN

La infección por Strongyloides stercoralis se inicia cuando las larvas filariformes del suelo penetran la piel, pasan por la circulación pulmonar, entran en las vías aéreas y son deglutidas. Las larvas maduran en la mucosa del intestino delgado transformándose en las hembras partenogénicas, depositan los huevecillos de donde se liberan las larvas rabditoides en las heces. Estas larvas L-1 permiten hacer el diagnóstico en las muestras del excremento, y se las identifica por la cápsula oral corta y el primordio genital prominente. En este artículo se revisa el ciclo vital y los avances recientes en la patogenia y patología de la strongyloidiasis. La inmunosupresión, particularmente aquélla ligada con niveles excesivos de corticosteroides, induce la aceleración marcada de la autoinfección y diseminación del parásito, dando por resultado el síndrome hiperinfeccioso, que a menudo se manifiesta como bronconeumonía hemorrágica, enteritis necroulcerosa, sepsis por Gram negativos o meningitis. En la hiperinfección, las larvas migrantes generan la hemorragia alveolar y las larvas suelen ser vistas en el examen citológico de la expectoración. Se revisan también las características epidemiológicas, el diagnóstico y los avances recientes en la quimioterapia antiparasitaria.


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