Asian Journal of Research in Infectious Diseases

Aims: Strongyloidiasis is an asymptomatic disease caused by the intestinal helminth Strongyloides stercoralis in immunocompetent individuals and are present for decades. The rarity of our case presents in the facts that an elderly gentleman being immunocompetent before, being evaluated for a surgical condition, circumstances lead to sudden deterioration and within one day of the biopsy report succumbs to the condition. While undergoing retrospective evaluation it was diagnosed as hyper infection and disseminated strongyloidiasis.

Presentation of the Case: 77 year old elderly male , a case of chronic idiopathic demyelinating neuropathy(recovered) , previously was on oral steroids for a period of 1-2 months; was admitted with persistent vomiting at other hospital, and on evaluation diagnosed with hiatus hernia with severe gastritis and referred to us, patient underwent Naso jejunal  tube placement in view of gastric outlet obstruction and for feeding, post which, patient had initially loose stools and thereafter malena, upper Gi scopy with cessation of bleed done, to recur as hematemesis and within one day of diagnosis of duodenal biopsy suggestive of Strongyloides stercoralis, patient succumbed to the disease.

Discussion: The case emphasizes on the importance of evaluation of various gastrointestinal infections especially caused by pathogens in our country with tropical climate and need to correlate the immunocompetency of patient especially on steroids with underlying infections.

Conclusion: strongyloidiasis infection should be ruled out in all the immunodeficient patients especially on steroids for brief periods and presenting with gastrointestinal symptoms of vomiting and diarrhoea.