Strongyloides stercoralis is a cause of abdominal pain, diarrhea and urticaria in rural Cambodia

BACKGROUND: We document clinical manifestations of 21 patients heavily infected with S. stercoralis (more than 250 larvae in a single Baermann test) from a community in rural Cambodia, both before and three weeks after ivermectin (200 μg/kg BW, single oral dose) treatment. FINDINGS: Out of 21 patients, 20 (95.2%), 18 (85.7%) and 14 (66.7%) reported frequent abdominal pain, diarrhea and periods of sensation of itching, respectively, during the previous six months; epigastric (11, 55.0%) and peri-umbilical (13, 65.0%) pains were most frequent. Five patients (23.8%) reported having experienced urticaria the week preceding the examination. One patient suffered from extended urticaria. Three weeks after treatment, most symptoms had been almost entirely resolved. CONCLUSIONS: In rural communities of Cambodia, strongyloidiasis with high parasite load is endemic. It is associated with substantial symptoms and clinical signs, particularly abdominal pain, diarrhea and urticaria. Access to adequate diagnosis and treatment is a pressing issue that needs attention.