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August 1996

Disseminated Strongyloidiasis in a Patient With Acquired Immunodeficiency Syndrome

Author Affiliations

Vancouver, British Columbia

Department of Dermatology, Box 0316 University of California, San Francisco 400 Parnassus Ave San Francisco, CA 94143

San Francisco

Arch Dermatol. 1996;132(8):977-978. doi:10.1001/archderm.1996.03890320127027

Strongyloides stercoralis, the "human threadworm," is an intestinal helminth with an estiestiglobal prevalence of 3 to 30 million.1 It is endemic to regions in the tropics and subtropics, including areas with high human immunodeficiency virus (HIV) prevalence, such as sub-Saharan Africa. Strongyloides parasites may cause disseminated systemic infection in immunocompromised patients. Less than 20 cases of disseminated strongyloidiasis have occurred in patients with acquired immunodeficiency syndrome (AIDS), and all but 2 cases were fatal.2 Moreover, only 2 skin eruptions have been reported, neither of which was confirmed as cutaneous infestation by biopsy.

Report of a Case.  A 25-year-old transsexual man who used intravenous drugs and had AIDs (CD4 T-helper cell count, 0.07 × 109/L [70 cells/μL]), was hospitalized with gastrointestinal complaints and a 14-kg weight loss. The patient emigrated from Mexico at age 3 years and had intestinal strongyloidiasis 1 year previously. His male sexual

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