Intestinal strongyloidiasis and hyperinfection syndrome

In spite of recent advances with experiments on animal models, strongyloidiasis, an infection caused by the nematode parasite Strongyloides stercoralis, has still been an elusive disease. Though endemic in some developing countries, strongyloidiasis still poses a threat to the developed world. Due to the peculiar but characteristic features of autoinfection, hyperinfection syndrome involving only pulmonary and gastrointestinal systems, and disseminated infection with involvement of other organs, strongyloidiasis needs special attention by the physician, especially one serving patients in areas endemic for strongyloidiasis. Strongyloidiasis can occur without any symptoms, or as a potentially fatal hyperinfection or disseminated infection. Th(2 )cell-mediated immunity, humoral immunity and mucosal immunity have been shown to have protective effects against this parasitic infection especially in animal models. Any factors that suppress these mechanisms (such as intercurrent immune suppression or glucocorticoid therapy) could potentially trigger hyperinfection or disseminated infection which could be fatal. Even with the recent advances in laboratory tests, strongyloidiasis is still difficult to diagnose. But once diagnosed, the disease can be treated effectively with antihelminthic drugs like Ivermectin. This review article summarizes a case of strongyloidiasis and various aspects of strongyloidiasis, with emphasis on epidemiology, life cycle of Strongyloides stercoralis, clinical manifestations of the disease, corticosteroids and strongyloidiasis, diagnostic aspects of the disease, various host defense pathways against strongyloidiasis, and available treatment options

Antimicrobial spectrum of honey for aerobic organisms as seen at the National Orthopaedic Hospital, Enugu

Background: Honey is an ancient topical wound dressing that has evoked international interest. The widespread use of honey on wounds is being encouraged but differences in its antimicrobial spectrum exist.There are few local laboratory studies available to guide clinicians in this environment, hence this study.Materials and methods: A sample of commercially prepared honey from the tropical bee species was obtained and used in this prospective study. The initial medium was a 1-in-3 dilution of pure honey-agarmixture. Against this was smeared isolates from aerobic cultures of wounds in the microbiology laboratory of the National Orthopaedic Hospital, and incubated at 370 C for 72 hours. Seventy-five samples are presentedin this on going study, of which 67 are consecutive samples. The rest are specific isolates of pathogenic organisms grown from patients’ wounds and cultured against the honey sample and incubated for 24hours.Eight such samples were further incubated up to 72 hours and checked. A crude flammability test for purity was applied to the honey sample before use.Results: Honey was found to inhibit the growth of common gram positive and negative organisms including multi-resistant Staphylococcus aureus. When the pure cultures were treated with honey for 72 hours and thenstreaked on agar plates, no aerobic organism grew thereafter, including those that had previously grown on the 1-in-3 honey-agar mixture.Conclusion: Routine laboratory honey antimicrobial spectrum provided by use of honey-agar mixture is recommended as a guide to its clinical use.Key words: honey, antimicrobial sensitivity, laboratory test