title: Strongyloidiasis: the cause of multiple gastrointestinal ulcers in an immunocompetent individual.
abstract: Strongyloidiasis is a common parasitic disease in tropical regions of the world. Infection with Strongyloides stercoralis usually remains asymptomatic with peripheral eosinophilia and uncontrolled growth. Consequently, immunocompromised individuals are at a higher risk of complications of this disease. We present a case of an immunocompetent patient whose complaint of acute abdominal pain was found to be due to gastric and duodenal ulcerations. Laboratory examination revealed significantly elevated absolute eosinophil count at 11,466/mm(3) (normal 0-700/mm(3)). The duodenal biopsy revealed parasitic ova and adult worms suggestive of Strongyloides stercoralis nematode with increased eosinophils in the tissue. We report the first case of multiple gastric and duodenal ulcerations due to Strongyloides stercoralis in an immunocompetent patient. We suggest that the elevated eosinophil count played a central role in the pathogenesis.
authors.affiliation: Department of Internal Medicine, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Shail
authors.initials: S
authors.lastname: Sheth
authors.affiliation: Department of Internal Medicine, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Fady
authors.identifier: 0000-0003-0744-2496
authors.initials: F
authors.lastname: Asslo
authors.affiliation: Department of Infectious Disease, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Rabih
authors.initials: R
authors.lastname: Hallit
authors.affiliation: Department of Infectious Disease, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Raymund
authors.initials: R
authors.lastname: Sison
authors.affiliation: Department of Infectious Disease, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Afridi
authors.affiliation: Department of Gastroenterology, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Spira
authors.affiliation: Department of Gastroenterology, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Depasquale
authors.affiliation: Department of Infectious Disease, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Jihad
authors.initials: J
authors.lastname: Slim
authors.affiliation: Department of Infectious Disease, Saint Michael's Medical Center, Newark, NJ 07102, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Boghossian