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- W2978568723 abstract "Introduction: We describe an interesting case of villous blunting caused by Strongyloidies stercolaris infection. Case description: 57-year-old female presented with one-week history of myalgias, chills and tactile fever. She also reported chornic diarrhea, intermittent abdominal pain and recent onset dry cough. She denied weight loss, dyspnea, melena, hematochezia, dysuria, pruritus and skin rash. She was originally from Michoacan, Mexico and had lived in United States for several years. She frequently visited a lake near her house in Micohoacan where she enjoyed walking barefoot. Previous travel to Mexico was three years prior to this encounter. Physical exam was notable for mild epigastric tenderness. Lab workup revealed anemia and leukocytosis. Previous workup was significant for peripheral eosinophilia, which had remained unexplained. ESR and CRP values were 36 and 4 respectively. CT scan of abdomen revealed submucosal fatty infiltration in distal duodenum and proximal jejunum. EGD findings were consistent with villous blunting and fissures in mid jejunum. Biopsy of this region revealed larvae of Strongyloides stercolaris. This was confirmed with a positive Strongyloides IgG serology. A diagnosis of Strongyloidiasis was made and treatment with ivermectin was initiated. Discussion: Villi are finger like projections of epithelial lining of intestinal wall, which are involved in absorption of nutrients. Villous blunting is defined by flattening of villi. It can be caused by a various conditions, which include celiac disease, autoimmune enteropathy, common variable immunodeficiency (CVID), peptic duodenitis, food allergies, giardiasis and viral enteritis. Strongyloidiasis can lead to broad range of endoscopic findings in small intestine, which include edema, brown discoloration, subepithilial hemorrhages and megaduodenum1. Strongyloides infection can cause duodenitis which leads to villous blunting and atrophy depending on degree of inflammation. Effects in jejunum have not been well described. Endoscopists must be aware that strongyloidiasis is a cause of villous blunting and keep a high index of suspicion in symptomatic patients who travel frequently to endemic areas, those who are immunosuppressed and recent immigrants.Figure 2Figure 1" @default.
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- W2978568723 date "2016-10-01" @default.
- W2978568723 modified "2023-09-27" @default.
- W2978568723 title "Strongyloidiasis: An Uncommon Cause of Villous Blunting" @default.
- W2978568723 doi "https://doi.org/10.14309/00000434-201610001-02173" @default.
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