Current Issue : January-March Volume : 2011 Issue Number : 1 Articles : 1 Articles
Although the prevalence of Strongyloides stercoralis (SS) in India is unknown, a report showed that about 15% of its study group (78 members of 15 families) were afflicted with SS.1 We would like to elucidate if immunocompromised state heightens susceptibility of SS by describing our experience. A 44 year old male with stigmata of decompensated chronic liver disease (alcohol related), presented with complaints of diffuse, continuous, dull aching abdominal pain and mucoid and watery loose motions for 2 days. On examination he was lean built and poorly nourished with pallor and dry skin. BP was 90/60mmHg, Heart rate- 104/min, Temperature- 100.8F. Abdomen was distended with engorged veins and a positive fluid-thrill (Figure 1). Labs showed S.Bilirubin -2.44mg/dl (Direct-1.37mg/dl), AST-122 IU/L, ALT-7 IU/L, S.Albumin-2.1gm/dl, Hb-8.0gm/dl. Ultrasonography showed shrunken liver with irregular border. Stool examination showed strongly motile rhabditiform larva of SS (Figure 2) and was negative for other ova and cysts. Ascitic fluid analysis showed high SAAG (Serum ascites albumin gradient) and was negative for any forms of SS. Ivermectin 200mcg/kg per day for 2 days was administered along with supportive treatment. Patient improved remarkably and repeat stool examinations were negative for S.stercoralis....
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