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Unusual association of diseases/symptoms
Case report
Strongyloides, HTLV-1 and small bowel obstruction
  1. Emily Martyn1,
  2. Betty Gration2,
  3. Chitra Subbiah Somasundaram3 and
  4. Peter L Chiodini4
  1. 1Microbiology Department, North Middlesex University Hospital NHS Trust, London, UK
  2. 2Division of Infection, University College London Hospitals, London, UK
  3. 3Gastroenterology Department, North Middlesex University Hospital NHS Trust, London, UK
  4. 4Department of Clinical Parasitology, Hospital for Tropical Diseases, London, UK
  1. Correspondence to Dr Emily Martyn; emily.martyn{at}nhs.net

Abstract

An 81-year-old Jamaican man who has been resident in the UK for many years presented with one week history of generalised abdominal pain, postprandial vomiting, anorexia, weight loss and abdominal distension. He was managed conservatively for acute small bowel obstruction. Investigations revealed a duodenal stricture. Live Strongyloides stercoralis larvae were observed in stool samples and duodenal biopsy confirmed the presence of the parasite at multiple life cycle stages within the lamina propria. He was diagnosed with Strongyloides hyperinfection with underlying human T-cell lymphotropic virus type 1 and treated with a prolonged course of ivermectin with ongoing monitoring for relapse. This case demonstrates a rare but potentially fatal cause of small bowel obstruction.

  • stomach and duodenum
  • tropical medicine (infectious disease)

https://doi.org/10.1136/bcr-2019-232461

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    Footnotes

    • Twitter @EmilyMartyn2

    • Correction notice This article has been corrected since it was first published online. The author's surname has been corrected from "Chitra Somasundaram" to "Chitra Subbiah Somasundaram".

    • Contributors All four authors (EM, BG, CS and PLC) contributed to the conception, design, acquisition and interpretation of data; helped to draft and revise the article; approved the final version; and agree to be accountable for the article and ensure that all the questions regarding accuracy or integrity of the article are investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.