Strongyloides stercoralis infestation associated with septicemia due to intestinal transmural migration of bacteria.
Strongyloides stercoralis infestation is common in the tropics and is usually asymptomatic. Patients with immunocompromised states may develop hyperinfection and fulminant disease. It has been suggested that bacteria accompany S. stercoralis during its passage across the bowel wall, resulting in systemic sepsis. Herein is a report on a 30-year-old man with S. stercoralis infestation and small bowel bacterial overgrowth presenting as malabsorption syndrome. He developed extensive duodenojejunal ulceration, septicemia and fatal hypokalemia. Blood and jejunal fluid grew Escherichia coli with the same antibiotic sensitivity patterns. This supports the hypothesis of migration of bacteria from the intestinal lumen as a cause of septicemia in patients with fulminant S. stercoralis infestation.
Ghoshal
Uday C
UC
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India. ghoshal@sgpgi.ac.in
Ghoshal
Ujjala
U
Jain
Manoj
M
Kumar
Arvind
A
Aggarwal
Rakesh
R
Misra
Asha
A
Ayyagari
Archana
A
Naik
Subhash R
SR
D000328:Adult; D000818:Animals; D018988:Bacterial Translocation; D004927:Escherichia coli Infections / Q000150:complications*; D006801:Humans; D007583:Jejunum / Q000382:microbiology; D008286:Malabsorption Syndromes / Q000209:etiology*; D008297:Male; D018805:Sepsis / Q000150:complications* / Q000382:microbiology; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications*