A Rare Cause of Pedunculated Polyps Caused by Strongyloides

Introduction: Strongyloidiasis is a systemic disease caused by the nematode Strongyloides stercoralis. Strongyloides is unique among parasites in that it can remain undetected for decades. Although patients may present with the typical symptoms of a skin rash, cough or diarrhoea, a rare manifestatio...

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Main Authors: Omer Yousaf, Arisha Carreon, Ibrahim Mohsin
Format: Article
Language:English
Published: SMC MEDIA SRL 2022-03-01
Series:European Journal of Case Reports in Internal Medicine
Subjects:
Online Access:https://www.ejcrim.com/index.php/EJCRIM/article/view/3008
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author Omer Yousaf
Arisha Carreon
Ibrahim Mohsin
author_facet Omer Yousaf
Arisha Carreon
Ibrahim Mohsin
author_sort Omer Yousaf
collection DOAJ
description Introduction: Strongyloidiasis is a systemic disease caused by the nematode Strongyloides stercoralis. Strongyloides is unique among parasites in that it can remain undetected for decades. Although patients may present with the typical symptoms of a skin rash, cough or diarrhoea, a rare manifestation of infection is pseudopolyposis in the colon. This case highlights the unique finding of pseudopolyposis in a patient with strongyloidiasis with negative stool studies. Case description: We present the case of an 81-year-old man with a delayed diagnosis of strongyloidiasis. The patient initially presented to the clinic for evaluation of productive cough and was treated empirically for bronchitis. He subsequently developed vomiting and diarrhoea with imaging revealing circumferential wall thickening of the ascending colon, consistent with colitis. Although stool tests were negative, the patient was treated with antibiotics, and then underwent a colonoscopy which revealed multiple polyps. Biopsy results confirmed Strongyloides infection. The patient was treated with ivermectin and improved. Discussion: This case describes the unique finding of colonic pseudopolyposis in a patient infected with Strongyloides in rural southwest Virginia. Strongyloidiasis is often misdiagnosed due to its non-specific gastrointestinal symptoms and the chronic nature of the disease. Although stool studies are routinely negative for parasitic infection, CT scan findings suggestive of colitis should be followed by colonoscopy with biopsy of any abnormal lesion in the right clinical context. Determining the definitive diagnosis in a timely manner is crucial for establishing the specific treatment and for resolution of the disease.
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spelling doaj.art-d59a68556c064d90a49e36908d0f88172022-12-22T03:06:30ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942022-03-0110.12890/2022_0030082543A Rare Cause of Pedunculated Polyps Caused by StrongyloidesOmer Yousaf0Arisha Carreon1Ibrahim Mohsin2Norton Community Hospital, Ballad Health, Norton, VA, USANorton Community Hospital, Ballad Health, Norton, VA, USANorton Community Hospital, Ballad Health, Norton, VA, USAIntroduction: Strongyloidiasis is a systemic disease caused by the nematode Strongyloides stercoralis. Strongyloides is unique among parasites in that it can remain undetected for decades. Although patients may present with the typical symptoms of a skin rash, cough or diarrhoea, a rare manifestation of infection is pseudopolyposis in the colon. This case highlights the unique finding of pseudopolyposis in a patient with strongyloidiasis with negative stool studies. Case description: We present the case of an 81-year-old man with a delayed diagnosis of strongyloidiasis. The patient initially presented to the clinic for evaluation of productive cough and was treated empirically for bronchitis. He subsequently developed vomiting and diarrhoea with imaging revealing circumferential wall thickening of the ascending colon, consistent with colitis. Although stool tests were negative, the patient was treated with antibiotics, and then underwent a colonoscopy which revealed multiple polyps. Biopsy results confirmed Strongyloides infection. The patient was treated with ivermectin and improved. Discussion: This case describes the unique finding of colonic pseudopolyposis in a patient infected with Strongyloides in rural southwest Virginia. Strongyloidiasis is often misdiagnosed due to its non-specific gastrointestinal symptoms and the chronic nature of the disease. Although stool studies are routinely negative for parasitic infection, CT scan findings suggestive of colitis should be followed by colonoscopy with biopsy of any abnormal lesion in the right clinical context. Determining the definitive diagnosis in a timely manner is crucial for establishing the specific treatment and for resolution of the disease.https://www.ejcrim.com/index.php/EJCRIM/article/view/3008colitispseudopolyposisstrongyloides stercoralispedunculated polyps
spellingShingle Omer Yousaf
Arisha Carreon
Ibrahim Mohsin
A Rare Cause of Pedunculated Polyps Caused by Strongyloides
European Journal of Case Reports in Internal Medicine
colitis
pseudopolyposis
strongyloides stercoralis
pedunculated polyps
title A Rare Cause of Pedunculated Polyps Caused by Strongyloides
title_full A Rare Cause of Pedunculated Polyps Caused by Strongyloides
title_fullStr A Rare Cause of Pedunculated Polyps Caused by Strongyloides
title_full_unstemmed A Rare Cause of Pedunculated Polyps Caused by Strongyloides
title_short A Rare Cause of Pedunculated Polyps Caused by Strongyloides
title_sort rare cause of pedunculated polyps caused by strongyloides
topic colitis
pseudopolyposis
strongyloides stercoralis
pedunculated polyps
url https://www.ejcrim.com/index.php/EJCRIM/article/view/3008
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