Cutaneous ulcer in chronic Strongyloides stercoralis infection: An unusual presentation

Abstract

Strongyloides stercoralis is a nematode parasite that infects human through penetration of the skin by infective filariform larvae, following walking barefoot in areas contaminated by human faeces containing the infective filariform larvae. In chronic strongyloidiasis, cutaneous manifestations are common and gastrointestinal symptoms are unusual. We report a case of cutaneous ulcerations due to S. stercoralis infection in an immunocompetent patient. Skin biopsy revealed increased eosinophils in the tissue with no larva of S. stercoralis. Microscopic examinations of stool wet mount revealed actively motile, multiple larvae which were confirmed as S. stercoralis larvae, using Baermann technique, by the presence of characteristic short buccal cavity and a large esophagus bulb. The patient was successfully treated with tablet ivermectin (9mg) daily for two consecutive days.