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      Diarrea crónica en paciente inmunocompetente Translated title: Chronic diarrhea in an immunocompetent patient

      case-report

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          Abstract

          RESUMEN Presentamos un caso de diarrea crónica en un paciente varón de 58 años que no tenía antecedentes personales de interés ni alteraciones conocidas en su estado inmunitario.

          Translated abstract

          SUMMARY We present a case of chronic diarrhea in a 58-year-old male patient with no relevant personal history and no known alterations in his immune status.

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          Manifestations, diagnosis, and treatment of Strongyloides stercoralis infection.

          Marisel Segarra-Newnham (2007)
          To summarize current literature on the manifestations, diagnosis, and treatment of Strongyloides stercoralis infection. A search was conducted of PubMed (1970-August 2007). Search terms included Strongyloides stercoralis, hyperinfection, prevention, and treatment. Reviews, studies, and recent case reports were included. Additional references were obtained from article bibliographies. All studies or review articles published in English from 1970 to August 2007 and case reports of hyperinfection or disseminated disease published since 2000 were evaluated. Strongyloidiasis is a parasitic infection endemic to tropical, subtropical, and temperate areas including the Appalachian region of the southern US. Prevalence rates vary widely. Patients may present with infection decades after original exposure. Diagnosis can be achieved by identifying the larvae in the stool; usually, more than one sample is needed. Most patients are asymptomatic. However, in immunosuppressed patients, a hyperinfection syndrome or disseminated disease may occur due to the ability of the parasite to reproduce within the host. The most common risk factors for these complications are immunosuppression caused by corticosteroids and infection with human T lymphotropic virus type 1. Treatment options for uncomplicated disease include thiabendazole, ivermectin, and albendazole. Thiabendazole has been replaced by ivermectin as treatment of choice due to better tolerance. These antihelminthics have been used to treat hyperinfection or disseminated disease alone or in combination, but data are limited to case reports or case series. Prevention of disease is mainly achieved by wearing shoes in endemic areas to avoid contact with infected soil. Strongyloides is a unique parasite that can cause a hyperinfection syndrome and disseminated infection several years after exposure. Treatment options include ivermectin, thiabendazole, or albendazole. Information on the best treatment for disseminated disease and hyperinfection is limited.
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            Diagnostic pathology of infectious diseases

            G. L. WOODS, Y Gutiérrez, GL Wood … (1993)
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              Is Gastric Involvement by Strongyloides stercoralis in an Immunocompetent Patient a Common Finding? A Case Report and Review of the Literature

              Irene Pecorella, Tom Okello, Gaia Ciardi … (2021)
              Purpose Gastric infection with Strongyloides stercoralis (SS) usually occurs in immunocompromised patients. The unexpected observation of this parasite in an otherwise healthy young lady who had undergone upper endoscopy and biopsy sampling of the gastro-duodenal mucosa, prompted us to review the literature to ascertain the conditions favouring gastric colonization by SS. Methods Pathology files of gastroduodenal biopsies received at St. Mary’s hospital, Northern Uganda, between 2007 and 2017 were reviewed. Pubmed search was performed under the headings “Strongyloides stercoralis”, “Gastric parasitosis”. Results Histology of the only gastroduodenal biopsy with SS infection showed parasite eggs, immature rhabditiform larvae, and numerous adult worms in gastric pits and rhabditiform larvae in interepithelial parasitic tunnels, causing reactive changes of the glandular epithelium. There was no significant acute inflammatory cell infiltrate surrounding the parasites. Literature review showed that gastric SS infection appears to be very uncommon and was, as expected, largely prevalent in immunodeficient individuals (84.2% of published cases). The rare gastric SS infection is a complication of systemic strongyloidiasis, either hyperinfective, or disseminated form. It is also commonly associated with duodenal infection at microscopical examination. Conclusion Involvement of gastric mucosa in the absence of duodenal strongyloidiasis appears to be quite rare and false-negative histopathological exams are reported if only the stomach is biopsied.
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                Author and article information

                Journal
                Journal ID (publisher-id): sm
                Title: Sanidad Militar
                Abbreviated Title: Sanid. Mil.
                Publisher: Ministerio de Defensa (Madrid, Madrid, Spain )
                ISSN (Print): 1887-8571
                Publication date (Print and electronic): March 2023
                Volume: 79
                Issue: 1
                Pages: 45-46
                Affiliations
                [1] Madrid orgnameHospital Central de la Defensa Gómez Ulla orgdiv1Servicio de Anatomía Patológica España
                [2] Madrid orgnameHospital Central de la Defensa Gómez Ulla orgdiv1Servicio de Anatomía Patológica España
                Article
                Publisher ID: S1887-85712023000100009 Publisher ID: S1887-8571(23)07900100009
                DOI: 10.4321/s1887-85712023000100009
                SO-VID: 67d9667b-cd0e-47e9-b98a-83c283497945
                License:

                http://creativecommons.org/licenses/by/4.0/

                History
                Date received : 21 October 2021
                Date accepted : 14 January 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 4, Pages: 2
                Product

                SciELO Spain

                Categories
                Subject: Comunicación Breve

                Keywords: Histopathology,Inmmunocompetent,Chronic diarrhea,Histopatología,Inmunocompetente,Diarrea crónica
                Data availability:
                Keywords: Histopathology, Inmmunocompetent, Chronic diarrhea, Histopatología, Inmunocompetente, Diarrea crónica

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