Article Text
Summary
Strongyloides stercoralis infection is usually asymptomatic but can result in a hyperinfection syndrome, most commonly triggered by acquired or iatrogenic immunosuppression. Here, we present a case of a man aged 60 years originally from a strongyloides endemic area with a medical history of alcohol abuse who presents with strongyloides hyperinfection syndrome (SHS) complicated by partial small bowel obstruction, pulmonary haemorrhage, large bandemia without eosinophilia and cardiac arrest resulting in death. This case is notable for the presence of bandemia and absence of eosinophilia, lack of historical risk factors for hyperinfection, specifically corticosteroid immunosuppressants, and dramatic decline in clinical status which ultimately resulted in the patient's death. Clinicians should suspect SHS in immunocompetent patients who are from an endemic area and who have persistent gastrointestinal and/or pulmonary manifestations in the absence of a clear cause.
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Footnotes
Contributors AM, CC, IA-S and NM were involved in the conception, literature review, drafting and editing of the manuscript. NM and AM were involved in the care of the patient and CC and IA-S conducted the pathology review and autopsy. AM and CC contributed equally to this paper.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.