2026 Volume 68 Issue 7 Pages 1297-1304
Strongyloidiasis is a parasitic gastrointestinal infection caused by Strongyloides stercoralis. Although often asymptomatic, co-infection with human T-cell leukemia virus type 1 (HTLV-1) or immunosuppression may develop into a severe form known as disseminated strongyloidiasis. Here, we report the case of a 63-year-old man undergoing chemoradiotherapy for lung cancer who presented to the emergency department with generalized weakness and diagnosed with septic shock of unknown origin, prompting antimicrobial therapy. During his clinical course, melena prompted an upper gastrointestinal endoscopy, which revealed edematous duodenal mucosa. Histopathological examination of the biopsy specimens confirmed the presence of Strongyloides stercoralis larvae. It was considered that hyperinfection had developed because of HTLV-1 co-infection and chemotherapy-induced immunosuppression. Based on a diagnosis of disseminated strongyloidiasis, treatment with ivermectin was initiated, leading to clinical improvement and survival until hospital discharge.
