DIAGNOSIS

1.      Demonstration of the rhabditiform larvae in freshly passed stool

·         This is the most important method of specific diagnosis

·         Larvae found in stale stools have to be differentiated from larvae hatched from hookworm eggs.

·         Larvae may sometimes be present in sputum and gastric aspirates

2.      Stool culture

·         When larvae are scanty in stool

·         The larvae develop into free-living forms and multiply in charcoal culture set up with stool

·         Large number of free-living larvae and adults can be seen after 7-10 days

3.       Serological test

·         Use strongyloides or filarial antigen

·         Complement fixation, indirect haemagglutination  and ELISA

·         But the antigens are not freely available, and extensive cross reactions limit the utility of these test

4.      Radiological

·         Radiological appearances in intestinal infections are said to be characteristic

·         Helpful in diagnosis

·         Obtain a chest radiograph to reveal possible patchy alveolar infiltrates in acute strongyloidiasis

·          In severe strongyloidiasis, findings are diverse; the chest radiograph may depict diffuse interstitial infiltrates, segmental or diffuse alveolar infiltrates, or pleural effusions.

5.      Full Blood Count

·         Peripheral eosinophilia is a constant finding

·         In severe hyperinfection eosinophilia may sometimes absent