A CASE OF SEVERE STRONGYLOIDIASIS DIAGNOSED BY ESOPHAGOGASTRODUODENOSCOPY AND TREATED SUCCESSFULLY WITH ANTHELMINTIC THERAPY

Abstract

An 87-year-old woman developed massive gastrointestinal bleeding a week after starting 40mg of prednisolone per day. Upper gastrointestinal endoscopy revealed friable gastroduodenal mucosa with a white coat. Strongyloides stercoralis was identified in biopsy specimens taken from gastric and duodenal mucosal lesions and in the stool sample. After a two-week course of ivermectin 9 mg a day, her general condition improved. In the case of gastrointestinal bleeding in patients receiving immunosuppressive therapy, we should consider the diagnosis of intestinal parasitosis. The findings of mucosal biopsy can help to diagnose intestinal parasitosis especially when extensive superficial inflammation and bleeding are observed endoscopically.