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evista de Gastroenterología de México. 2015;80(4):280---281
www.elsevier.es/rgmx
REVISTA DEGASTROENTEROLOGIA
DE MEXICO´
´
LINICAL IMAGE IN GASTROENTEROLOGY
isseminated gastrointestinal strongyloidiasis�
strongiloidiasis gastrointestinal diseminada
.M. Antolinez-Mottab, F. Chablé-Monteroa, A. Torreb,∗
Departamento de Patología, Fundación Clínica Médica Sur, Mexico City, Mexico
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provided by Elsevier - Publis
Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Figure 1 Gastroduodenal endoscopy showing white villi in thesecond portion of the duodenum.
trongyloides stercoralis is a nematode capable of produc-ng an asymptomatic infection; it is endemic in tropical andubtropical regions. Immunocompromised patients are par-icularly susceptible. It is considered a dangerous conditionn this population, especially when disseminated diseases associated with hyperinfection. A 72-year-old man had
history of previously treated chronic myeloid leukemia,ow in remission for a period of 10 years. He was admit-ed to the hospital with a 3-month history of diarrhea,o evidence of bloody stools or parasites, colicky-typebdominal pain, persistent fatigue, and weight loss. Phys-cal examination revealed a slightly distended abdomennd no other abnormalities. Laboratory work-up showed aeukocyte count of 31,900 �L, eosinophils 15,950 �L (50%),nd neutrophils 5,724 �L; the other tests were within theormal range. Upper and lower endoscopy was performednd revealed mild duodenal atrophy and colonic erythema.ndoscopic biopsy specimens from the duodenal and colonicucosa revealed numerous rhabditiform larvae, and intense
osinophilic-rich acute and chronic inflammatory infiltrate.he diagnosis of duodenal and colonic strongyloidiasis wasstablished (Figs. 1-3).
� Please cite this article as: Antolinez-Motta JM, Chablé-Montero, Torre A. Estrongiloidiasis gastrointestinal diseminada. Revista deastroenterología de México. 2015;80:280---281.∗ Corresponding author. Departamento de Gastroenterología,
nstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,asco de Quiroga 15 Col. Sección XVI Del. Tlalpan México D.F. 14000,el.: +52 55 5487 0900, Ext.: 2711.
E-mail address: [email protected] (A. Torre).
255-534X/© 2015 Asociación Mexicana de Gastroenterología. Publishedhe CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-n
by Masson Doyma México S.A. This is an open access article underd/4.0/).
Disseminated gastrointestinal strongyloidiasis
Figure 2 Duodenal mucosa with mild atrophy. The cryptsshow numerous rhabditiform larvae of Strongyloides sterco-ralis. The lamina propria shows an intense eosinophilic-richacute and chronic inflammatory infiltrate (H&E, x100).
Figure 3 Higher magnification of the duodenal mucosa shownin Figure 2. The larvae are in the lumen of the crypts and
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Conflict of interest
The authors declare that there is no conflict of interest.
produce reparative changes of the intestinal epithelium. The
inflammatory response with abundant eosinophils is clearly seenin the lamina propria (H&E, x300).281
thical responsibilities
rotection of persons and animals. The authors declarehat no experiments were performed on humans or animalsor this study.
ata confidentiality. The authors declare that they haveollowed the protocols of their work center in relation tohe publication of patient data.
ight to privacy and informed consent. The authors havebtained the informed consent of the patients and/or sub-ects referred to in the article. This document is in theossession of the corresponding author.
inancial disclosure
o financial support was received in relation to this article.