title: Strongyloides duodenitis: case report and review of literature.
abstract: Strongyloides stercoralis affects 30 to 100 million people worldwide and is a common cause of abdominal pain and diarrhea. Strongyloidiasis is a chronic and limited disease; however, in immunocompromised patients, hyperinfection syndrome can occur. Diagnosing strongyloidiasis early is important, as almost all deaths due to helminths in the United States are due to S stercoralis hyperinfection. Patients infected with human immunodeficiency virus (HIV) do not appear to be at an increased risk for S stercoralis hyperinfection. We report a case of an HIV-infected Hispanic woman presenting with dyspepsia, emesis, abdominal pain, and diarrhea diagnosed with S stercoralis on an esophagogastroduodenoscopy biopsy of the duodenum. The diagnostic workup had been inconclusive and deciding to biopsy the small bowel based on the nonerythematous boggy appearance of the duodenal folds was the key step in making the correct diagnosis. Early diagnosis and treatment thwarted the developing hyperinfection syndrome and likely prevented further morbidity and probably saved her life.
authors.affiliation: Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA. bkakati@uams.edu
authors.forename: Bobby
authors.initials: B
authors.lastname: Kakati
authors.forename: Shyam
authors.initials: S
authors.lastname: Dang
authors.forename: Muhannad
authors.initials: M
authors.lastname: Heif
authors.forename: Kari
authors.initials: K
authors.lastname: Caradine
authors.forename: William
authors.initials: W
authors.lastname: McKnight
authors.forename: Farshad
authors.initials: F
authors.lastname: Aduli
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000818:Animals; D004382:Duodenitis / Q000469:parasitology* / Q000473:pathology; D016145:Endoscopy, Digestive System; D005260:Female; D015658:HIV Infections; D006801:Humans; D016867:Immunocompromised Host; D007413:Intestinal Mucosa / Q000469:parasitology; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D015163:Superinfection / Q000517:prevention & control