Strongyloides stercoralis related gastritis in seventeen patients

Abstract

We present seventeen cases of hyperinfection by Strongyloides stercoralis with the presence of the parasite in the gastric antrum, diagnosed by endoscopic biopsies, a finding that confirms the syndrome, seen at the Hospital Universitario del Valle, between 1987 and 1997. The mean age was 34 years with a range between 10 and 77 years. There were 11 male and 6 female patients. Predisposing factors were infection by HTLV-I (6), HIV (1) and prolonged steroid therapy (1). Seven patients died from different causes: sepsis (4), GI bleeding (1), myocardial infarction (1), and cause unknown (1). In four patients bacteremia by E. coli, P.mirabilis and S.aureus was demonstrated. At the time of diagnosis the average duration of symptoms was 3 months, albumin values were between 1.1 and 2.8 gr./dl (average 1.7 gr./dl), cholesterol between 44 and 128 mg/dl (average 94 mg/dl) and hemoglobin between 4.7 and 14.3 (average 9.9 gr./dl). Endoscopic findings were erythema of the antrum in 15 patients and prepyloric erosions in 2 patients. Histology confirmed the presence of the parasite in the antrum in all cases. We consulted MEDLINE database and found only 16 cases of this syndrome described in the literature. Due to the implications that the finding of the parasite in the stomach has on the diagnosis of the syndrome of hyperinfection and therefore in the treatment, we emphasize the importance of obtaining gastric biopsies in patients with possible risk factors for developing the syndrome such as HTLV-I.