Iranian Journal of Pathology

Gastric Strongyloides Stercoralis in a Patient with Inflammatory Myopathy

Document Type : Case Reports

Authors

Farahnaz Bidari Zerehpoosh 1
Arman Ahmadzadeh 2
Alireza Farahmand 2
Mahboobeh Chahkandi 1
Hossein AliMohammadi 3

1 Dept. of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Dept. of Rheumatology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Dept. of Emergency MedicineShahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract
Strongyloides stercoralis is a free living tropical and semitropical soil nematode which its larva penetrates skin. It can complete its life cycle in human body and causes autoinfection. Most patients have no frank symptoms. But respiratory, gastrointestinal and skin manifestation may occur. We report a 76 year old man admitted to emergency room with muscle weakness, dyspnea, nausea, vomiting while receiving prednisolone 60 mg/d plus methotrexate 15 mg intramuscular injections per week for his underlying polymyositis. His upper endoscopy showed an ulcer and microscopic examination revealed S. stercoralis larvae and adult worm in gastric mucosa. He was treated with a combination of parenteral ivermectin and oral albendazole, the disease course ended in complete improvement with clearing of daily stool samples after more than 2 weeks of treatment. It is noteworthy that the pre-steroid stool examinations were negative for parasites.
 

Keywords

Strongyloides stercoralis
Gastric Ulcer
Myopathy
  1. Kim J, Joo H, Kim D, Lim H, Kang Y, Kim M. A case of gastric strongyloidiasis in a Korean patient. Korean J Parasitol 2003;41(1):63-7.
  2. Giannella RA, Broitman SA, Zamcheck N. Influence of gastric acidity on bacterial and parasitic enteric infections. Ann Intern Med 1973;78:271–6.
  3. Nielsen PB, Mojon M. Improved diagnosis of Strongyloides stercoralis by seven consecutive stool specimens. Zentralbl Bakteriol Mikrobiol Hyg A 1987;263:616–8.
  4. 4.Siddiqui A, Berk S. Diagnosis of Strongyloides stercoralis infection. Clin Infect Dis 2001;33(7):1040-7.
  5. 5.Hamilton KW, Abt PL, Rosenbach MA, Bleicher MB, Levine MS, Mehta J, et al. Donor-derived Strongyloides stercoralis infections in renal transplant recipients. Transplantation 2011;91(9):1019-24.
  6. 6.Oztürk G, Aydınlı B, Celebi F, Gürsan N. Gastric perforation caused by Strongyloides stercoralis: a case report. Ulus Travma Acil Serrahi Derg 2011;17(1):90-2.
  7. Altintop L, Cakar B, Hokelek M, Bektas A, Yildiz L, Karaoglanoglu M. Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis and bronchial asthma: a case report. Ann Clin Microbiol Antimicrob 2010;9:27.
  8. Moghadam KG, KhashayarP, Hashemi M. Gastrointestinal strongyloidiasis in immunocompromised patients, a case report. Indones J Intern Med 2011;43(3):191-4.
  9. Luis A,Marcos, Angelica, Terashima, Cannales M, Gotuzzo E. Update on strongyloidiasis in the immunocompromised Host. Curr Infect Dis Rep 2011;13:35-46.
  10. Berk SL, Verghese A, Alvarez S, Hall K, Smith B. Clinical and epidemiologic features of strongyloidiasis. A prospective study in rural Tennessee. Arch Intern Med 1987;147:1257–61.
  11. Ghoshal U, Alexander G, Tripathi S, Krishnani N. Strongyloides Stercoralis infestation in a patient with severe ulcerative colitis. Indian J Med Sci 2006;60(3):106-10.
  12. Concha R, Harrington WJ, Rogers A. Intestinal strongyloidosis: recognition, management and determinants of outcome. J Clin Gastroenterol 2005;39:203-11.
  13. Igra-Siegman Y, Kapila R, Sen P, Kaminski ZC, Louira DB. Syndrome of hyperinfection with Strongyloides stercoralis. Rev Infect Dis 1981;3:397-407.
Iranian Journal of Pathology
Volume 8, Issue 3 - Serial Number 3
Summer 2013
Pages 184-188

  • Receive Date 22 April 2012
  • Accept Date 17 November 2012

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