Rare disease
A young man with bowel obstruction and cachexia
1 North Middlesex Hospital, Flat F, 30 Greencroft Gardens, London NW6 3LT, UK
2 North Middlesex Hospital, Sterling Way, London N18 1QX, UK
3 The University of South Manchester NHS Trust, Southmoor Road, Manchester M23 9LT, UK
Correspondence to:
badrivv{at}aol.com
A young man from Jamaica was admitted with cachexia, postprandial epigastric pain and vomiting. His abdominal examination revealed a soft abdomen with hyperactive bowel sounds, the laboratory investigations showed mild anaemia and hypoalbuminaemia, and abdominal x ray showed dilated and oedematous bowel loops. A duodenal biopsy revealed larvae and eggs in the epithelium consisted with Strongyloides infection. In retrospect the patient was found to be HTLV-1 positive. Helminthic infections can present with bowel obstruction even in the absence of eosinophilia or diarrhoea, and should be considered in patients with the appropriate epidemiological background.
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