There appears to be no doubt that gentian violet is at the moment the drug of choice for the treatment of human strongyloidiasis. The oral regimen (0.06 gm. gentian violet medicinal in 1½ hour enteric coated tablets t.i.d. until 3.3 gm. have been administered (1)) is apparently widely used, supplemented at times by the transduodenal intubation of a solution of the drug. There are, however, at least two disadvantages to enteral therapy in this disease: the length of the therapeutic course necessary before the stools become larva-free—sometimes amounting to several months—and the failure of the drug to be absorbed from the gastrointestinal tract; the enterally administered dye does not reach the stages of the organism which do the greatest harm—the migrating larvae of the initial infection and of the auto- and hyperinfection stages.
During the management of several cases of strongyloidiasis, it became necessary to treat patients in whom there was dangerous active larval migration, as evidenced by pulmonary inflltratioias and renal hemorrhage, with larvae demonstrable in the sputum and urine.