Feature Article

Diagnosis and management of helminth infections

Feature Article

Diagnosis and management of helminth infections

David I Grove

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Abstract

There are several endemic worm infections in Australia, enterobiasis being the most common, as well as a variety of exotic species infections that may be seen in returned travellers. Selecting an appropriate anthelmintics to treat a particular infection is important.

Key Points

  • In Australia, most patients who have worms are infected with the common threadworm, Enterobius vermicularis. Pruritus ani is the most common symptom.
  • Most worms cannot multiply within humans. (Note that Strongyloides stercoralis is an exception to this general rule.)
  • E. vermicularis infection is diagnosed by finding eggs deposited on the perianal skin, not in the faeces.
  • If a patient has enterobiasis, treat the whole family.
  • Infection with S. stercoralis can persist for decades and overwhelming infection may supervene in immunosuppressed patients.
  • Think of brachylaimiasis in a rural patient with unexplained diarrhoea who may have ingested infected snails.
  • If you suspect an exotic infection, refer the patient to your nearest expert in tropical and infectious diseases.