[Histological diagnosis of strongyloidiasis in the Medical Unit of High Specialty of Puebla].

BACKGROUND

Strongyloides stercolaris is one of the most important intestinal nematodes due to its worldwide distribution. It’s estimated that it affects 50 to 100 million people in 70 countries of the world. In a large percentage of cases it is asymptomatic, however, patients with immunosuppression may present more serious symptoms. The life cycle of this parasite comprises two phases: one as a free-living organism and the other as a parasite. The objective of this case report is to describe the histological findings compatible with this parasitosis and the importance of recognizing them in order to provide adequate and timely treatment.

CASE REPORT: This is a 37-year-old male patient who began his condition in December 2018, with an acute respiratory condition that occurs after a diarrheal event. Due to the initial evolution, the presumptive diagnosis of Crohn’s disease was made, treated with prednisone without showing improvement. During follow-up, stomach and duodenal biopsies were performed, among others, which allowed the detection of S. stercolaris, which was managed with ivermectin.

CONCLUSIONS

The case presented agrees with what is referred to in the consulted literature, as it demonstrates the wide spectrum of clinical manifestations, the relationship with immunosuppression states and how frequent it is to make a first-instance erroneous diagnosis. Likewise, it exemplifies the difficulty involved in making the diagnosis of a parasitosis through histological study, due to the particularities of the parasite itself, as well as the little familiarity that the surgical pathologist may have due to how unusual this pathology is outside of tropical environments.