Spurious pseudomembranous enteritis in strongyloidiasis

A fatal case of Strongyloidiasis, unsuspected until postmortem microscopy, is presented. At autopsy, the gross changes in the small bowel of the patient suggested pseudomembranous enteritis. The "membrane" consisted of inspissated barium sulphate from a gastrointestinal series 2 wk before death, nematodes, and proteinaceous material. We believe these findings to be unique. It is possible that bowel hypomotility, known to occur in Strongyloidiasis, favored retention and inspissation of barium sulphate, thus starting a vicious cycle favoring further stasis with increased susceptibility to burrowing worms and augmented auto-infection.