Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease
Autoinfection caused by Strongyloides stercoralis frequently becomes a life-long disease unless it is effectively treated. There is overlapping histomorphology between Strongyloides colitis and inflammatory bowel disease; a low index of suspicion can lead to misdiagnosis and fatal consequences. We p...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Pathology |
| Online Access: | http://dx.doi.org/10.1155/2017/2560719 |
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| author | Julio Poveda Farah El-Sharkawy Leopoldo R. Arosemena Monica T. Garcia-Buitrago Claudia P. Rojas |
| author_facet | Julio Poveda Farah El-Sharkawy Leopoldo R. Arosemena Monica T. Garcia-Buitrago Claudia P. Rojas |
| author_sort | Julio Poveda |
| collection | DOAJ |
| description | Autoinfection caused by Strongyloides stercoralis frequently becomes a life-long disease unless it is effectively treated. There is overlapping histomorphology between Strongyloides colitis and inflammatory bowel disease; a low index of suspicion can lead to misdiagnosis and fatal consequences. We present a case of Strongyloides colitis mimicking the clinical and pathologic features of inflammatory bowel disease. A 64-year-old female presented to the emergency department with a four-day history of abdominal pain, diarrhea, and hematochezia. Colonoscopy revealed diffuse inflammation suggestive of inflammatory bowel disease, which led to initiation of 5-aminosalicylic acid and intravenous methylprednisolone. Biopsies of the colon revealed increased lymphoplasmacytic infiltrate of the lamina propria with eosinophilic microabscesses and presence of larvae, consistent with Strongyloides stercoralis. Immunosuppressive medication was halted. The patient ultimately died a few days later. This case emphasizes the importance of identifying the overlapping clinical and pathologic features of Strongyloides colitis and inflammatory bowel disease. A high index of suspicion and recognition of particular histological findings, including eosinophilic microabscesses, aid in the correct diagnosis. Definitive diagnosis is crucial as each disease carries distinct therapeutic implications and outcome. |
| format | Article |
| id | doaj-art-bba11f17c8d64b2e80b8ac3cb12aa550 |
| institution | Kabale University |
| issn | 2090-6781 2090-679X |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pathology |
| spelling | doaj-art-bba11f17c8d64b2e80b8ac3cb12aa5502025-02-03T05:53:55ZengWileyCase Reports in Pathology2090-67812090-679X2017-01-01201710.1155/2017/25607192560719Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel DiseaseJulio Poveda0Farah El-Sharkawy1Leopoldo R. Arosemena2Monica T. Garcia-Buitrago3Claudia P. Rojas4Department of Pathology, University of Miami Health System/Jackson Memorial Hospital, 1611 NW 12th Ave, Holtz Center 2142D, Miami, FL 33136, USADepartment of Pathology, University of Miami Health System/Jackson Memorial Hospital, 1611 NW 12th Ave, Holtz Center 2142D, Miami, FL 33136, USADepartment of Gastroenterology, University of Miami Health System/Jackson Memorial Hospital, 1475 NW 12th Ave, Miami, FL 33136, USADepartment of Pathology, University of Miami Health System/Jackson Memorial Hospital, 1611 NW 12th Ave, Holtz Center 2142D, Miami, FL 33136, USADepartment of Pathology, University of Miami Health System/Jackson Memorial Hospital, 1611 NW 12th Ave, Holtz Center 2142D, Miami, FL 33136, USAAutoinfection caused by Strongyloides stercoralis frequently becomes a life-long disease unless it is effectively treated. There is overlapping histomorphology between Strongyloides colitis and inflammatory bowel disease; a low index of suspicion can lead to misdiagnosis and fatal consequences. We present a case of Strongyloides colitis mimicking the clinical and pathologic features of inflammatory bowel disease. A 64-year-old female presented to the emergency department with a four-day history of abdominal pain, diarrhea, and hematochezia. Colonoscopy revealed diffuse inflammation suggestive of inflammatory bowel disease, which led to initiation of 5-aminosalicylic acid and intravenous methylprednisolone. Biopsies of the colon revealed increased lymphoplasmacytic infiltrate of the lamina propria with eosinophilic microabscesses and presence of larvae, consistent with Strongyloides stercoralis. Immunosuppressive medication was halted. The patient ultimately died a few days later. This case emphasizes the importance of identifying the overlapping clinical and pathologic features of Strongyloides colitis and inflammatory bowel disease. A high index of suspicion and recognition of particular histological findings, including eosinophilic microabscesses, aid in the correct diagnosis. Definitive diagnosis is crucial as each disease carries distinct therapeutic implications and outcome.http://dx.doi.org/10.1155/2017/2560719 |
| spellingShingle | Julio Poveda Farah El-Sharkawy Leopoldo R. Arosemena Monica T. Garcia-Buitrago Claudia P. Rojas Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease Case Reports in Pathology |
| title | Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease |
| title_full | Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease |
| title_fullStr | Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease |
| title_full_unstemmed | Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease |
| title_short | Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease |
| title_sort | strongyloides colitis as a harmful mimicker of inflammatory bowel disease |
| url | http://dx.doi.org/10.1155/2017/2560719 |
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