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Vol. 80. Issue 4.
Pages 280-281 (October - December 2015)
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Vol. 80. Issue 4.
Pages 280-281 (October - December 2015)
Clinical image in Gastroenterology
Open Access
Disseminated gastrointestinal strongyloidiasis
Estrongiloidiasis gastrointestinal diseminada
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J.M. Antolinez-Mottab, F. Chablé-Monteroa, A. Torreb,
Corresponding author
detoal@yahoo.com

Corresponding author. Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15 Col. Sección XVI Del. Tlalpan México D.F. 14000, Tel.: +52 55 5487 0900, Ext.: 2711.
a Departamento de Patología, Fundación Clínica Médica Sur, Mexico City, Mexico
b Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Strongyloides stercoralis is a nematode capable of producing an asymptomatic infection; it is endemic in tropical and subtropical regions. Immunocompromised patients are particularly susceptible. It is considered a dangerous condition in this population, especially when disseminated disease is associated with hyperinfection. A 72-year-old man had a history of previously treated chronic myeloid leukemia, now in remission for a period of 10 years. He was admitted to the hospital with a 3-month history of diarrhea, no evidence of bloody stools or parasites, colicky-type abdominal pain, persistent fatigue, and weight loss. Physical examination revealed a slightly distended abdomen and no other abnormalities. Laboratory work-up showed a leukocyte count of 31,900μL, eosinophils 15,950μL (50%), and neutrophils 5,724μL; the other tests were within the normal range. Upper and lower endoscopy was performed and revealed mild duodenal atrophy and colonic erythema. Endoscopic biopsy specimens from the duodenal and colonic mucosa revealed numerous rhabditiform larvae, and intense eosinophilic-rich acute and chronic inflammatory infiltrate. The diagnosis of duodenal and colonic strongyloidiasis was established (Figs. 1-3).

Figure 1.

Gastroduodenal endoscopy showing white villi in the second portion of the duodenum.

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Figure 2.

Duodenal mucosa with mild atrophy. The crypts show numerous rhabditiform larvae of Strongyloides stercoralis. The lamina propria shows an intense eosinophilic-rich acute and chronic inflammatory infiltrate (H&E, x100).

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Figure 3.

Higher magnification of the duodenal mucosa shown in Figure 2. The larvae are in the lumen of the crypts and produce reparative changes of the intestinal epithelium. The inflammatory response with abundant eosinophils is clearly seen in the lamina propria (H&E, x300).

(0.23MB).
Ethical responsibilitiesProtection of persons and animals

The authors declare that no experiments were performed on humans or animals for this study.

Data confidentiality

The authors declare that they have followed the protocols of their work center in relation to the publication of patient data.

Right to privacy and informed consent

The authors have obtained the informed consent of the patients and/or subjects referred to in the article. This document is in the possession of the corresponding author.

Financial disclosure

No financial support was received in relation to this article.

Conflict of interest

The authors declare that there is no conflict of interest.

Please cite this article as: Antolinez-Motta JM, Chablé-Montero F, Torre A. Estrongiloidiasis gastrointestinal diseminada. Revista de Gastroenterología de México. 2015;80:280–281.

Copyright © 2015. Asociación Mexicana de Gastroenterología
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