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Experimental Infection of Mice with the Parasitic Nematode Strongyloides ratti ratti Infection
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Disseminated strongyloidiasis after prolonged treatment with corticosteroids
Caitlin Mahoney1, Carina Murphy Brown1, Brittany McIntyre1
1Family Medicine, Cone Health, Greensboro, North Carolina, USA.
BMJ Case Reports
|July 14, 2022
Summary
Strongyloides stercoralis, a soil-transmitted helminth, can cause disseminated disease, especially in immunocompromised individuals. This case highlights a rare presentation of disseminated strongyloidiasis and oesophageal candidiasis.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Gastroenterology
Background:
- Strongyloides stercoralis is a soil-transmitted helminth prevalent in tropical regions.
- Infections typically cause mild or asymptomatic disease.
- Disseminated strongyloidiasis is a severe complication, often seen in immunocompromised hosts.
Observation:
- A woman presented with persistent nausea, vomiting, and epigastric pain.
- Investigations included imaging and oesophagogastroduodenoscopy with biopsy.
- Biopsy revealed oesophageal candidiasis and disseminated strongyloidiasis.
Findings:
- Key historical factors included prolonged steroid use, recent gram-negative bacteraemia, and prior residence in Rwanda.
- The patient had received unknown predeparture treatment for Strongyloides stercoralis.
- Diagnosis was confirmed via biopsy findings.
Implications:
- This case underscores the importance of considering disseminated strongyloidiasis in patients with relevant exposure history and risk factors.
- Prompt diagnosis and treatment with ivermectin and fluconazole led to significant symptom improvement.
- Highlights the need for awareness of Strongyloides stercoralis in endemic areas and among immunocompromised populations.
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