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August 1980

Strongyloidiasis in Immunosuppressed Hosts: Presentation as Massive Lower Gastrointestinal Bleeding

Author Affiliations

From the Division of Respiratory and Environmental Medicine (Drs Powell and Anderson), Department of Surgery (Dr Moss), University of Louisville School of Medicine (Drs Nagar, Melo, and Cheng), and Department of Pathology, Jewish Hospital, Louisville (Dr Boram).

Arch Intern Med. 1980;140(8):1061-1063. doi:10.1001/archinte.1980.00330190073023

• Two cases of massive lower gastrointestinal hemorrhage in immunosuppressed patients were due to complicated infestation with Strongyloides stercoralis. The very high mortality of disseminated strongyloidiasis may in part be attributed to delays in diagnosis and treatment resulting from the complex life cycle of this nematode. Successful therapy in the cases presented consisted of reduction of corticosteroid dosage, use of thiabendazole in excess of that recommended for uncomplicated infestation, parenterally administered nutrition, multiple transfusion of blood products, and vigorous supportive management. Emphasis is given to proper categorization of patients and measures designed to prevent, detect, and treat hyperinfection in patients in whom immunosuppression is anticipated.

(Arch Intern Med 140:1061-1063, 1980)