TITLE:
Strongyloides stercoralis in an immunocompetent adult: An unexpected cause of weight lost
AUTHORS:
Lia Marques, André Rodrigues, Elisa Vedes, Dores Marques
KEYWORDS:
Strongyloides stercoralis; Immunocompetent; Hyperinfection
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.7,
October
22,
2013
ABSTRACT: Strongyloides
stercoralis infects at
least 100 million humans worldwide each year, but its prevalence is
underestimated. It is endemic in hot and humid climates as well as resource
poor countries with inadequate sanitary conditions. The rise of international
travel and immigration has a positive impact in strongyloidiasis. Due to its
unique auto infection life-cycle, Strongyloides may lead to chronic
infections remaining undetected for decades. Strongyloidiasis is most often
asymptomatic but it has a wide range of clinical presentations. The two most severe forms of strongyloidiasis are
hyperinfection and disseminated syndromes. These occur most often in patients
with impaired cell mediated immunity. A 42-year-old immunocompetent man
presented with chronic watery diarrhea, malaise, upper abdominal pain,
anorexia and weight lost. Strongyloides stercoralis was identified in
stool samples and duodenal biopsy. The patient was successfully treated
with albendazole. The authors report a case of strongyloidiasis hyperinfection
in an immunocompetent host 20 years away from an endemic area and make a
literature review.