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STRONGYLOIDES HYPER INFECTION SYNDROME

Pankaj Desai 1, Mayank V Kabrawala 1, Chintan Patel 1, Ritesh Prajapati 1, Rinkalben Kakadiya 1

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1 SIDS Hospital & Research Centre, Surat, India

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Clinical Case Summary

Background: Strongyloides stercoralis is a clinically inapparent chronic infection in an immunocompetent individual. However, infection by the same parasite in immunosuppressed individuals can lead to hyper infection syndrome and disseminated disease which have an alarmingly high case fatality rate. There have been only case reports of this disease. We here present a case series of Strongyloides stercoralis infection that were diagnosed in our institution.
Methods: We present 5 cases with strongyloidiasis, in immunosuppressed patients.
Results: Most common age group - 40 to 50 years with 90% males. Underlying comorbidities were diabetes, rheumatological disorders. Patients with rheumatological disorders were on steroids or immunomodulators. Most common presenting symptoms -abdominal pain(100%), vomiting(80%), fever(66%), diarrhoea(40%) and pedal edema/ascites(20%). Diagnosis of Strongyloidiasis by Upper GI scopy showing duodenal ulcers/ erosions/ fissuring, with biopsies showing larval and egg forms of the parasite in the duodenal mucosa in all patients. In 70% cases single stool examination failed to detect larva by conventional methods but stool routine micro yielded the diagnosis in one patient. All the patients were prescribed ivermectin and other supportive treatment. No mortality was seen in our study. In various published study the mortality rate for S. stercoralis hyperinfection was 87%, however none of the patients in our study succumb to the infection. This may be related to prompt starting of anti-helmenthic medications along with adequate medical and intensive care wherever needed.
Conclusion: Strongyloides Hyper infection syndrome if treated promptly with adequate medications can yield favorable results even in immunocompromised individuals. In contrast to the available literature suggesting high mortality in hyperinfection syndrome this case series did not record any mortality.

Disclosure

The authors have nothing to disclose

Conference

UEG Week Copenhagen 2023

Topics

Small Intestine & Nutrition

Submission format

Clinical Case

Session

PP 12 Clinical Cases (Posters)

Published

2023

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A PROSPECTIVE, SINGLE-CENTER, RANDOMIZED, OPEN-LABEL STUDY TO INVESTIGATE EFFICACY AND LONG-TERM OUTCOME OF CYANOACRYLATE GLUE FOR ALL GASTRIC VARICES (GOV1, GOV2, IGV1, IGV2) VERSUS ITS USE ONLY GOV 2 AND IGV 1 GASTRIC VARICES WITH STIGMA OF RECENT HAEMO

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