Severe Strongyloides stercoralis Infection in Yazd, Mimicking Ulcerative Colitis

Abstract

Background: Infection with Strongyloides stercoralis, an intestinal nematode of humans and some animals, is rare in dry climates such as Yazd. This article presents a patient with this infection who was mistakenly under treatment for ulcerative colitis, which recovered after proper diagnosis and anti-helminthic therapy. Case presentation: A 32 years-old man from Qeshm referred to Yazd Central Laboratory in August 2005, when many rhabditiform larvae of S. stercoralis were found in stool exam. Until then, he was under treatment with sulfasalazine and other drugs for ulcerative colitis. Treatment with tiabendazole was completely effective at relieving intestinal symptoms, without recurrence in 15 months of follow-up. All lab reports and documents are available. Conclusion: Careful attention is necessary because delayed diagnosis of S. stercoralis may lead to severe and fatal strongyloidiasis, and this parasite can manifest itself with symptoms similar to other intestinal diseases, such as ulcerative colitis.