title: Shiga toxin producing E coli bloodstream infection secondary to Strongyloides penetration through intestinal mucosa.
abstract: A 51-year-old woman with diabetes, who immigrated to the USA 22 years ago from Laos, was admitted to the hospital for evaluation of fever, abdominal pain, vomiting and diarrhoea. A workup for acute gastroenteritis revealed a positive stool PCR for Shiga toxin-producing Escherichia coli. Two sets of blood cultures drawn at admission were positive for E coli. A review of her previous medical records revealed the presence of eosinophilia, up to 20%, 14 years prior to that was never investigated. Therefore, stool samples were examined and two of three specimens were positive for Strongyloides stercoralis larvae, confirming the diagnosis of Strongyloides hyperinfection syndrome.
authors.affiliation: Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Sancta
authors.initials: S
authors.lastname: St Cyr
authors.forename: Avish
authors.initials: A
authors.lastname: Nagpal
authors.forename: Muhammad Rizwan
authors.initials: MR
authors.lastname: Sohail
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000209:etiology*; D060085:Coinfection / Q000382:microbiology / Q000469:parasitology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004927:Escherichia coli Infections / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D054323:Shiga-Toxigenic Escherichia coli; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications*
references.citation: Infect Dis Clin North Am. 2012 Jun;26(2):513-54
references.pmid: 22632652
references.citation: Expert Opin Pharmacother. 2004 Dec;5(12):2615-9
references.pmid: 15571478
references.citation: J Clin Microbiol. 2007 Feb;45(2):438-42
references.pmid: 17151215
references.citation: Am J Epidemiol. 1990 Aug;132(2):257-64
references.pmid: 2196791
references.citation: Trop Geogr Med. 1993;45(4):179-80
references.pmid: 8236470
references.citation: Trop Biomed. 2010 Apr;27(1):115-9
references.pmid: 20562820
references.citation: Clin Microbiol Rev. 2004 Jan;17(1):208-17
references.pmid: 14726461
references.citation: South Med J. 1999 Jan;92(1):58-60
references.pmid: 9932829
references.citation: Indian J Med Microbiol. 2010 Oct-Dec;28(4):407-8
references.pmid: 20966585