What Does it Take to ‘Sew Up’ a Diagnosis?

Threadworm Infection: What Does it Take to ‘Sew Up’ a Diagnosis?

Smith, Linda A

Infection with Strongyloides stercoralis may be asymptomatic or may mimic many different intestinal conditions. Unless there is a high index of suspicion on the part of the physician, the infection can remain undiagnosed for years. This case is that of a 39-year-old male with a ten-year history of repeated bouts of intestinal cramping, distention, and diarrhea. He had been treated for irritable bowel syndrome without resolution of symptoms. Results of laboratory tests performed during the most recent visit to the physician demonstrated decreased hemoglobin, hematocrit, and white blood cell count. There was 16% eosinophilia present. As a result of the persistence of intestinal symptoms and the increased eosinophil count, an endoscopy was performed. Biopsy of tissue taken during the endoscopy revealed eosinophilic infiltration. Examination of the duodenal aspirate demonstrated the presence of Strongyloides stercoralis filariform larvae. The patient was treated and the infection was resolved.

Linda A Smith PhD CLS(NCA), Kelli M Kammlah, The University of Texas Health Science Center, San Antonio TX.

Copyright American Society for Clinical Laboratory Science Summer 2004

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