Massive gastrointestinal strongyloidiasis following corticosteroid therapy presenting with erythroderma and generalised lymphadenopathy

Abstract

AbstractA case of Strongyloides stercoralis hyperinfection is described in a retired miner with erythroderma and diabetes mellitus, in a prelymphoma stage, treated with corticosteroids. On admission the patient was excreting massive quantities of rhabditiform and filariform larvae of Strongyloides stercoralis and also parasite ova were detected in his stool. The authors assume the Strongyloidex Stercoratis was a case of hyperinfection despite the negative results of histological examination of biopsies taken from lesions on perianal and gluteal regions. In the patient's biochemical profile the shift of immunologic parameters to levels of immunodeficiency, high values of total IgE without eosinophilia, and high values of proteins were indicative of acute inflammation. The patient's condition included extensive loss of body mass (14 kg) and repeated attacks of bacterial infection of the skin associated with fever. The patient did not report any symptoms indicating disturbances of the gastrointestinal tract cither before or during treatment. After antiparasitic treatment the stool became parasitologically negative, and it remained negative also in follow‐up examinations, and the general condition of the patient improved. However, 6 months later the skin biopsy revealed a malignant lymphoma, mycosis fungoides.