Drug of choice of Strongyloides stercoralis
**Core Concept**
Strongyloides stercoralis is a parasitic nematode that causes strongyloidiasis, a disease characterized by chronic gastrointestinal and respiratory symptoms. The treatment of choice for strongyloidiasis involves the use of anthelmintic medications that can effectively target and eliminate the parasite.
**Why the Correct Answer is Right**
The drug of choice for strongyloidiasis is ivermectin, a macrocyclic lactone that acts by binding to glutamate-gated chloride channels in the parasite's nervous system, leading to muscle paralysis and ultimately, the death of the parasite. Ivermectin is effective in treating both the larval and adult stages of the parasite, making it an ideal treatment option. Additionally, ivermectin is also effective in treating other parasitic infections, such as onchocerciasis and lymphatic filariasis.
**Why Each Wrong Option is Incorrect**
**Option A:** Albendazole is a benzimidazole anthelmintic that is effective against a wide range of parasites, including hookworms and roundworms, but it is not the drug of choice for strongyloidiasis.
**Option B:** Praziquantel is a broad-spectrum anthelmintic that is effective against schistosomes and other flatworms, but it is not effective against Strongyloides stercoralis.
**Option C:** Pyrantel is an anthelmintic that is effective against hookworms and roundworms, but it is not the drug of choice for strongyloidiasis.
**Clinical Pearl / High-Yield Fact**
It is essential to note that patients with strongyloidiasis who are immunocompromised, such as those with HIV/AIDS, are at risk of developing hyperinfection syndrome, a life-threatening complication of the infection. Ivermectin is the treatment of choice for hyperinfection syndrome as well.
**Correct Answer: B. Praziquantel is a broad-spectrum anthelmintic that is effective against schistosomes and other flatworms, but it is not effective against Strongyloides stercoralis.