Gastroduodenal involvement in disseminated strongyloidiasis

Abstract

Here, we report the case of a 57-year-old Peruvian man on long-term corticosteroid therapy for a drug allergy and proton pump inhibitors for chronic dyspepsia symptoms. Upper gastrointestinal endoscopy showed multiple white granular lesions and widespread erosions in the stomach. Our findings indicate that gastric strongyloidiasis should be carefully considered in high-risk patients even if endoscopic findings are nonspecific.

Keywords: Strongyloides stercoralis; endoscopy; parasitic infection; stomach; strongyloidiasis.

Figure 1

Upper gastrointestinal endoscopy showed multiple white granular lesions resembling xanthoma in the antrum (a, b) and widespread erosion surrounded by granular lesions in the gastric body (c). None of these endoscopic findings existed 8 months previously (d). Upper gastrointestinal endoscopy also showed diffuse duodenal white villi and edematous papilla of Vater (e), which did not exist 8 months previously (f). Biopsy specimens taken from white granular lesions in the antrum showed nonspecific histopathological findings such as atrophic gastric mucosa and lymphocytic infiltration (g). Direct microscopic examination of gastric fluid revealed crawling filariform larvae of Strongyloides stercoralis (white arrow) (h).