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Clinical Medicine Insights: Case Reports

Twenty-five Years of Chronic Strongyloidiasis in an Immigrant

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Clinical Medicine Insights: Case Reports 2017:10 1179547616684828

Case report

Published on 08 Feb 2017

DOI: 10.1177/1179547616684828


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Abstract

Chronic strongyloidiasis is an infection of the tropical regions, caused by the nematode Strongyloides stercoralis. In the United States, patients are typically immigrants. The very long asymptomatic phase followed by the clinical presentation of the disease mimics asthma, chronic obstructive pulmonary disease (COPD), or inflammatory bowel disease (IBD) as in this case report. The inconsistency of eosinophilia and the low sensitivity of microscopic stool examination make chronic strongyloidiasis a disease that is frequently misdiagnosed in the United States. The use of corticosteroids in these misdiagnosed cases transforms chronic strongyloidiasis into disseminated strongyloidiasis or hyperacute syndrome, which leads to high mortality. Iatrogenic errors represent the essential cause of mortality due to chronic strongyloidiasis in the United States. We recommend a high index of suspicion of chronic strongyloidiasis when a physician approaches an immigrant presenting with symptoms mimicking asthma, COPD, and IBD with subcutaneous masses.



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