Invasive enteritis by Strongyloides stercoralis presenting as acute abdominal distress under corticosteroid therapy.
Overwhelming helminthiasis is still a problem in endemic areas, especially in immunocompromised patients. We report a case of invasive intestinal strongyloidiasis that was clinically expressed as acute abdominal distress in a 73-year-old man from São Paulo who had been receiving methylprednisone, 20 mg/day, for one year for osteoarthritis. A surgical specimen from the ileum revealed invasive enteritis with severe infestation by Strongyloides stercoralis. The patient died of sepsis 6 days after surgery. The possibility of invasive strongyloidiasis should be considered in the differential diagnosis of acute abdominal distress in patients undergoing immunosuppressive therapy.
Rodrigues
M A
MA
Division of Gastroenterology, Botucatu Medical School, University of the State of São Paulo, Brazil.
Fróes
R C
RC
Anefalos
A
A
Kobayasi
S
S
D000006:Abdomen, Acute / Q000469:parasitology* / Q000473:pathology; D000368:Aged; D004751:Enteritis / Q000150:complications / Q000469:parasitology* / Q000473:pathology; D017809:Fatal Outcome; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D010003:Osteoarthritis / Q000188:drug therapy; D013322:Strongyloidiasis / Q000150:complications* / Q000473:pathology
D005938:Glucocorticoids; D008775:Methylprednisolone