title: A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia.
abstract: Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.
authors.affiliation: Department of Pathology, Command Hospital (Air Force), Bengaluru, Karnataka, India.
authors.forename: Deepti
authors.initials: D
authors.lastname: Mutreja
authors.forename: Kartik
authors.initials: K
authors.lastname: Sivasami
authors.forename: Vanmalini
authors.initials: V
authors.lastname: Tewari
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Nandi
authors.forename: G Lakhsmi
authors.initials: GL
authors.lastname: Nair
authors.forename: Sunita D
authors.initials: SD
authors.lastname: Patil
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000818:Animals; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007010:Hyponatremia / Q000209:etiology; D015440:Leprosy, Lepromatous / Q000150:complications / Q000188:drug therapy; D008297:Male; D018805:Sepsis / Q000209:etiology* / Q000473:pathology*; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss