Clin Endosc.  2019 Jan;52(1):80-82. 10.5946/ce.2018.078.

Strongyloidiasis Presenting as Yellowish Nodules in Colonoscopy of an Immunocompetent Patient

• Ra H
• Chung JW
• Chung DH
• Kim JH
• Kim YJ
• Kim KO
• Kwon KA
• Park DK

• KMID: 2438150
• DOI: http://doi.org/10.5946/ce.2018.078

Abstract

Strongyloides stercoralis is endemic to tropical and subtropical regions, and infections are usually asymptomatic. However, immunocompromised patients, such as those receiving immunosuppressive therapy, high-dose steroids, or chemotherapy, can develop fatal hyperinfections. An 84-year-old man without any symptoms was diagnosed with strongyloidiasis during a regular screening colonoscopy. His medical history only involved a gastric endoscopic submucosal dissection for early gastric cancer 6 months previously. Few cases have been published about asymptomatic strongyloidiasis diagnosed in an immunocompetent host via endoscopic mucosal resection with characteristic colonoscopic findings. We report a case of colon-involved asymptomatic strongyloidiasis with specific colonic findings of yellowish-white nodules. This finding may be an important marker of S. stercoralis infection, which could prevent hyperinfections.

Keyword

Colonoscopy; Endoscopic mucosal resection; Strongyloidiasis

MeSH Terms

Aged, 80 and over
Colon
Colonoscopy*
Drug Therapy
Humans
Immunocompromised Host
Mass Screening
Steroids
Stomach Neoplasms
Strongyloides stercoralis
Strongyloidiasis*
Steroids

Figure

• 

  Fig. 1. Colonoscopic findings showing (A) multiple yellowish nodules and polyps in the ascending colon, and (B) yellowish nodules were found on the top of a polyp (before treatment). (C) The nodules disappeared after treatment.

• 

  Fig. 2. Histological findings. Numerous cross-sectioned filariform larvae (arrow) with distortion of crypts and diffuse eosinophilic infiltration are visible in the lamina propria of the colon (hematoxylin and eosin, ×200).

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