Chronic Relapsing Colitis due to Strongyloides Stercoralis

Alison J. Berry Department of Medicine and Department of Pathology, The University of Texas Medical Branch, Galveston, Texas 77550

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Earl G. Long Department of Medicine and Department of Pathology, The University of Texas Medical Branch, Galveston, Texas 77550

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Jerome H. Smith Department of Medicine and Department of Pathology, The University of Texas Medical Branch, Galveston, Texas 77550

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William K. Gourley Department of Medicine and Department of Pathology, The University of Texas Medical Branch, Galveston, Texas 77550

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Douglas P. Fine Department of Medicine and Department of Pathology, The University of Texas Medical Branch, Galveston, Texas 77550

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The small intestine is the usual site of chronic infection with Strongyloides stercoralis. Colonic involvement has generally been seen in the hyperinfection syndrome in immunosuppressed individuals. We describe an immunologically competent female who underwent multiple abdominal operations over a 5-year period for hematochezia and diffuse abdominal pain of obscure etiology. Eosinophilia had been present but never investigated until 1981, at which time stool examination revealed S. stercoralis larvae. Pathological specimens from operations in 1977 and 1981 demonstrated extensive colonic wall invasion with filariform larvae consistent with S. stercoralis. Involvement of other organs was never documented. We believe this case is consistent with chronic colitis due to strongyloidiasis. This entity has not been previously described, and expands the spectrum of this disease.

Author Notes

Present address: Division of Infectious Diseases, Medical College of Virginia, Richmond, Virginia 23219.

Present address: Infectious Disease Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104.

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