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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 12-13

An uncommon presentation of strongyloidiasis


Department of Gastroenterology, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai 400 008, Maharashtra, India

Date of Submission08-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Suhas Sudhkarrao Udgirkar
Department of Gastroenterology, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai 400 008, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1890_19

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How to cite this article:
Junare PR, Udgirkar SS. An uncommon presentation of strongyloidiasis. Indian J Med Res 2020;152, Suppl S1:12-3

How to cite this URL:
Junare PR, Udgirkar SS. An uncommon presentation of strongyloidiasis. Indian J Med Res [serial online] 2020 [cited 2021 Jul 29];152, Suppl S1:12-3. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/12/316735

Patient's consent obtained to publish clinical information and images.


A 30 yr old immunocompetent male presented with anasarca of one month to the department of Gastroenterology, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai, India, in March 2019. On evaluation, haemoglobin (10.9 g/dl) and serum protein (2.8 g/dl) were low; other laboratory findings were normal. Computed tomographic scan of the abdomen showed jejunoileal fold pattern reversal with mesenteric lymphadenopathy [Figure 1]; upper gastrointestinal endoscopy showed duodenal fissuring [Figure 2]A; laparoscopy showed prominent mesenteric lymph nodes [Figure 2]B; histopathological examination showed larvae and eggs of Strongyloides [Figure 3]A, [Figure 3]B, [Figure 3]C. A diagnosis of strongyloidiasis complicating protein-losing enteropathy was made.Faecal alpha 1-antitrypsin clearance suggested protein-losing enteropathy. The patient was treated with two days of oral ivermectin and was asymptomatic on seven months of follow up.
Figure 1: Contrast-enhanced computed tomography scan of abdomen showing jejunoileal folds pattern reversal: Featureless jejunal loops (upper red arrow) and increased mucosal folds in the ileal loops (lower red arrow).

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Figure 2: (A) Upper gastrointestinal endoscopic picture showing severe duodenal fissuring. (B) Laparoscopic picture showing ileal loops with enlarged mesenteric lymph nodes (red arrow).

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Figure 3: (A) Histopathology photomicrograph showing duodenal mucosa with multiple eggs of Strongyloides stercoralis (H and E, ×10). (B) Histopathology photomicrograph showing filariform larvae of Strongyloides stercoralis (H and E, ×40).

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Acknowledgment: Authors thank Dr Rima Kamat, department of Pathology, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai, for making histopathologic diagnosis and providing histopathology images for the case presented.

Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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