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A case of strongyloidiasis accompanied by duodenal ulcer
S Y Kim,N Y Kim,K H Lee,M S Gu,*J Y Chai,J Kook and S H Lee
Department of Internal Medicine, Kang Nam General Hospital Public Corporation, Seoul 135-090, Korea.
*Department of Clinical Pathology, Kang Nam General Hospital Public Corporation, Seoul 135-090, Korea.
Department of Parasitology, Seoul National University College of Medicine, Seoul 110-799, Korea.
Abstract
A 58-year-old chronic alcoholism patient, who complained of epigastric discomfort, nausea, and frequent loose stool was diagnosed as strongyloidiasis accompanied by duodenal ulcer. The symptoms first appeared two years ago and aggravated during the recent 3 months, and he lost 4 kg of his body weight. Stool examination revealed rhabditoid nematode larvae, which were confirmed as those of Strongyloides stercoralis after cultivation of them to filariform larvae. At duodenoscopy, duodenal ulcer was found. The patient was treated with albendazole (200 mg, bid, for 14 days) for strongyloidiasis and with colloidal bismuth sulfate (240 mg, bid, for 6 weeks) for duodenal ulcer. After the medication, the symptoms of loose stool and epigastric discomfort were much improved and he was discharged with no clinical problems. This is an interesting case which suggests that S. stercoralis infection could be related with ulceration of the duodenal mucosa.
Figures
Figs. 1-2 Fig. 1. A rhabditoid form larva of S. stercoralis found from the stool of this patient. (EB: esophageal bulb), Bar=100 µm.
Fig. 2a. A filariform larva of S. stercoralis from fecal culture. (FE: filariform esophagus), Bar=100 µm. 2b. Notched tail of a filariform larva of S. stercoralis from fecal culture. (NT: Notched tail), Bar=50 µm.
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