unrecognized strongyloides stercoralis infection in hemodialysis patient with recurrent diarrhea and readmissions

نویسندگان

palash samanta department of internal medicine, new york medical college, metropolitan hospital center, new york, usa; md, division of infectious diseases, department of internal medicine, university of pittsburgh medical center, falk medical building, suite 3a 3601 fifth avenue, pittsburgh, pa 15213, usa. tel: +1-4126470996, fax: +1-4126473162

ashok chaudhari department of internal medicine, division of nephrology, new york medical college, metropolitan hospital center, new york, usa

roger mendoza carbajal department of internal medicine, division of nephrology, new york medical college, metropolitan hospital center, new york, usa

چکیده

conclusions although strongyloidiasis is not endemic in usa, immigration obscured the geographical barrier of endemicity. the diagnosis can be difficult because of nonspecific symptoms and lack of sensitivity of microscopic diagnosis. although eosinophilia is a common finding in patients with chronic strongyloidiasis, it is unreliable indicator of active infection, especially in immunosuppressed condition. eosinophil count also may be falsely high in patients with hemodialysis. as laboratory diagnosis is mainly based on microscopic identification of larvae in the stool, examination of multiple stool samples is warranted to increase the yield of diagnosis. case presentation here we present a case of strongyloidiasis in hemodialysis patient requiring multiple admissions. although the patient had high eosinophil count in previous admissions, eosinophil count was normal when the diagnosis was made. introduction strongyloidiasis can vary from asymptomatic infection to life-threatening multisystem disease especially in immunocompromised patients. although strongyloidiasis is a rare diagnosis in usa, transmission through immigrants and refugees obscured the geographical boundary. the clinical presentations vary widely depending on underlying comorbidities and immunosuppression.

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عنوان ژورنال:
archives of clinical infectious diseases

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