Review Question - QID 109392

This patient presenting with both pulmonary and abdominal symptoms after a rash is most likely infected with Strongyloides stercoralis, which is transmitted through penetration of the skin.

Strongyloides stercoralis is a roundworm that is transmitted through contact penetration of the skin and is found around the world, including the southeastern United States. The most common route of penetration is through bare feet. The parasite subsequently undergoes blood-borne transmission to the lung, which then results in pulmonary symptoms. Coughing and swallowing the larvae leads to autoinfection of the intestine.

Incorrect Answers:
Answer 1: Inhalation of spores can lead to mycotic infection such as histoplasmosis. The pulmonary findings in Strongyloides are due to blood-borne transmission after initial skin penetration.

Answer 3: Animal bites can transmit some bacteria (such as Pasteurella) and viruses (such as rabies). They are not a common cause of transmission of Strongyloides.

Answer 4: Insect bites, particularly from flies, can lead to roundworm infections such as by Onchocerca volvulus. Strongyloides is not transmitted by insect bites.

Answer 5: Sexual contact is not associated with roundworm infection.

Bullet Summary:
Strongyloides stercoralis is a roundworm that causes both abdominal and pulmonary symptoms and is transmitted to humans through contact penetration of the skin.