Strongyloides Hyperinfection Presenting as a Gastric Outlet Obstruction

Abstract

Strongyloides is a unique nematode in its ability to cause a secondary hyperinfection and disseminated disease several years following initial contact. The prevalence of Strongyloides infection has been rising; it is currently considered a global disease, which presents with a broad spectrum of clinical signs and symptoms among patients. This case report focuses on a 67-year-old Caribbean female presenting with severe weight loss, vomiting, early satiety, and mild anemia who was subsequently diagnosed with strongyloidiasis on the basis of a duodenal biopsy pathology report obtained via esophagogastroduodenoscopy (EGD).

A Case of Ulcerated Gastric Mass and Anemia due to Strongyloidiasis

“…The case we described had gastric strongyloidiasis as part of his disseminated strongyloidiasis. Cases of disseminated strongyloidiasis with gastroduodenal involvement, including multiple granular lesions, ulcerations, and even duodenal obstruction, have been reported in the literature [ 9 , 10 ]. However, this is the first case of disseminated strongyloidiasis in which a patient presented with an ulcerated gastric mass and iron deficiency anemia.…”

Rare Complication of Strongyloidiasis in Vietnam: A Case of Venous Thromboembolism and Duodenal Obstruction

“…A negative stool result cannot exclude Strongyloidiasis because of the high false negative rate (up to 70% cases), probably due to the low parasite load and irregular larval output. 1,3,10 Multiple studies have suggested that obtaining 3-7 serial stool samples can significantly improve the diagnostic sensitivity from 50-99%. 1,3,10 On the other hand, the limitations of these tests include cross-reactions with other parasites and the prolonged persistence of antibodies even after treatment, making it difficult to distinguish between acute and chronic conditions based solely on the serum antibody levels.…”

“…1,3,10 Multiple studies have suggested that obtaining 3-7 serial stool samples can significantly improve the diagnostic sensitivity from 50-99%. 1,3,10 On the other hand, the limitations of these tests include cross-reactions with other parasites and the prolonged persistence of antibodies even after treatment, making it difficult to distinguish between acute and chronic conditions based solely on the serum antibody levels. 11 In this case, the patient tested positive for several parasites, which may be a cross-reaction or being infected by multiple endemic agents.…”

“…Chronic strongyloidiasis is an infrequently reported and often underrated infection with nonspecific gastrointestinal symptoms. [1][2][3] The clinical presentation of a Strongyloides stercoralis infection can vary from mild to severe, with a severe and disseminated infection potentially leading to serious complications in immunocompromised patients. 4 Despite their rarity, duodenal obstruction and venous thrombosis are possible complications of strongyloidiasis.…”