Clin Endosc.  2019 Jan;52(1):80-82. 10.5946/ce.2018.078.

Strongyloidiasis Presenting as Yellowish Nodules in Colonoscopy of an Immunocompetent Patient

Affiliations
  • 1Department of Internal Medicine, Gachon University of Medical and Science, Incheon, Korea. drgreen@gilhospital.com
  • 2Department of Pathology, Gachon University of Medical and Science, Incheon, Korea.

Abstract

Strongyloides stercoralis is endemic to tropical and subtropical regions, and infections are usually asymptomatic. However, immunocompromised patients, such as those receiving immunosuppressive therapy, high-dose steroids, or chemotherapy, can develop fatal hyperinfections. An 84-year-old man without any symptoms was diagnosed with strongyloidiasis during a regular screening colonoscopy. His medical history only involved a gastric endoscopic submucosal dissection for early gastric cancer 6 months previously. Few cases have been published about asymptomatic strongyloidiasis diagnosed in an immunocompetent host via endoscopic mucosal resection with characteristic colonoscopic findings. We report a case of colon-involved asymptomatic strongyloidiasis with specific colonic findings of yellowish-white nodules. This finding may be an important marker of S. stercoralis infection, which could prevent hyperinfections.

Keyword

Colonoscopy; Endoscopic mucosal resection; Strongyloidiasis

MeSH Terms

Aged, 80 and over
Colon
Colonoscopy*
Drug Therapy
Humans
Immunocompromised Host
Mass Screening
Steroids
Stomach Neoplasms
Strongyloides stercoralis
Strongyloidiasis*
Steroids

Figure

  • Fig. 1. Colonoscopic findings showing (A) multiple yellowish nodules and polyps in the ascending colon, and (B) yellowish nodules were found on the top of a polyp (before treatment). (C) The nodules disappeared after treatment.

  • Fig. 2. Histological findings. Numerous cross-sectioned filariform larvae (arrow) with distortion of crypts and diffuse eosinophilic infiltration are visible in the lamina propria of the colon (hematoxylin and eosin, ×200).


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