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Intestinal Strongyloides causing peritoneal eosinophilia in peritoneal dialysis
Sharmeela Saha1, Salyka Sengsayadeth2, Thomas A Golper1
1Department of Medicine/Nephrology , Vanderbilt University Medical Center , Nashville, TN , USA.
Clinical Kidney Journal
|June 13, 2015
Summary
Peritoneal eosinophilia in a patient on peritoneal dialysis can indicate Strongyloides infection. Early diagnosis and ivermectin treatment are crucial for effective management of this parasitic infection.
Area of Science:
- Infectious Diseases
- Nephrology
- Parasitology
Background:
- A 59-year-old male on peritoneal dialysis (PD) presented with abdominal pain and peritoneal eosinophilia.
- Initial empirical treatment for bacterial peritonitis was unsuccessful, with no pathogens isolated from PD fluid.
Purpose of the Study:
- To highlight Strongyloides stercoralis as a potential cause of peritoneal eosinophilia in patients undergoing peritoneal dialysis.
- To emphasize the importance of considering atypical infections in the differential diagnosis of peritoneal eosinophilia.
Main Methods:
- Case report of a patient with multiple myeloma on PD.
- Diagnostic workup included PD fluid analysis, serum Strongyloides IgG testing, and stool microscopy.
- Treatment involved ivermectin.
Main Results:
- The patient developed a partial small bowel obstruction.
- Serum Strongyloides IgG was positive.
- Stool examination confirmed Strongyloides stercoralis larvae after ivermectin treatment.
Conclusions:
- Peritoneal eosinophilia can be a manifestation of Strongyloides infection in PD patients.
- The differential diagnosis for peritoneal eosinophilia should include parasitic infections.
- Prompt identification and treatment of Strongyloides are essential.
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