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March 1989


Author Affiliations

Tampa, Fla

Arch Intern Med. 1989;149(3):717-721. doi:10.1001/archinte.1989.00390030155038

To the Editor.—In recent years, the United States has become host to an unprecedented number of immigrants from temperate climates. It is from these regions that infection with the nematode Strongyloides stercoralis is endemic. The increasing frequency by which Strongyloides is being seen in the United States is, in part, a result of this immigration.

Strongyloides is an intestinal nem

(Continued on p 721.)

(Continued from p 717.) atode that is acquired by skin contact with contaminated soil. The rhabditiform larvae easily penetrate intact skin or buccal mucosa, enter the lymphatic system, and are carried to the lungs. In contrast with other nematodes, these larvae produce very little inflammatory response in these tissues. They burrow from the lung capillaries, enter the alveoli, climb up the respiratory tree, and are swallowed. On reaching the duodenum, the larvae have reached sexual maturity. The larvae mate and the fertilized female burrows into

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