title: [Strongyloides stercoralis in a patient with ankylosing spondylitis: case report].
abstract: Strongyloidiasis is a nematode-borne disease caused by several Strongyloides species. This case was presented in order to indicate Strongyloidosis in immunocompromised patients with several clinical findings. A fifty-five year old male patient on corticosteroid medication for a long time because of ankylosing spondylitis was on infliximab medication for 5 years. He presented with swelling of his right foot for ten days, right shoulder stiffness and low back pain. The presence of anaemia was remarkable. S. stercoralis was reported in histological examination of endoscopic duodenal biopsy specimen. Peripheral blood smear showed 68.4% neutrophils, 17% lymphocytes, 7.5% monocytes, and 6.7% (normal range 2%-6.2) eosinophils. The level of IgE was raised: 285IU/mL (normal range 5-120IU/mL). A large number of S. stercoralis larvae were detected upon stool examination with saline and iodine mounts and the formaldehyde ether concentration method. After treatment with two cure albendazole 400 mg/day for 7 days, S. stercoralis larvae were not detected in stool examination. It is interesting that response to treatment was not observed on the first cure and the recovery was seen on the second cure. We suggest that hyperinfections should be taken into consideration in the diagnosis and treatment of immunocompromised patients with several complaints so that life-threatening effects of the nematode may be prevented.
authors: Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Samsun, Turkey.
authors: Keramettin
authors: K
authors: Yanık
authors: Adil
authors: A
authors: Karadağ
authors: Hakan
authors: H
authors: Odabaşı
authors: Nevzat
authors: N
authors: Unal
authors: Levent
authors: L
authors: Altıntop
authors: Murat
authors: M
authors: Hökelek
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000969:Antinematodal Agents / Q000627:therapeutic use; D004386:Duodenum / Q000469:parasitology; D005243:Feces / Q000469:parasitology; D006801:Humans; D016867:Immunocompromised Host; D000069285:Infliximab; D007814:Larva; D008297:Male; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000188:drug therapy; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000969:Antinematodal Agents; D000069285:Infliximab; D015766:Albendazole