Strongyloides colitis is a lethal mimic of ulcerative colitis: the key morphologic differential diagnosis

Human Pathology

Volumn 40, Issue 4, 2009, Pages 572-577

  Qu, Zhenhong ^a   Kundu, Uma R ^a   Abadeer, Rania A ^a   Wanger, Audrey ^a  

^a UNIVERSITY OF TEXAS MEDICAL SCHOOL   (United States)

Author keywords

Diagnostic error; Differential diagnosis; Strongyloides colitis; Ulcerative colitis

Indexed keywords

ALBENDAZOLE; ANTHELMINTIC AGENT; CORTICOSTEROID; IVERMECTIN; METHOTREXATE; PREDNISONE;

ADULT; AGED; ARTICLE; CELL INFILTRATION; CLINICAL ARTICLE; CLINICAL FEATURE; COLITIS; COLON MUCOSA; COLONOSCOPY; CORTICOSTEROID THERAPY; CRYPT CELL; DIAGNOSTIC ERROR; DIFFERENTIAL DIAGNOSIS; DISEASE COURSE; DRUG EFFICACY; EOSINOPHIL; FATALITY; FEMALE; HISTOLOGY; HUMAN; IMMUNOMODULATION; INFLAMMATION; MALE; MORTALITY; OUTCOME ASSESSMENT; RHEUMATOID ARTHRITIS; STRONGYLOIDES STERCORALIS; STRONGYLOIDES STERCORALIS COLITIS; STRONGYLOIDIASIS; SUBMUCOSA; ULCERATIVE COLITIS;

ADULT; AGED; AGED, 80 AND OVER; ANIMALS; COLITIS; COLITIS, ULCERATIVE; DIAGNOSIS, DIFFERENTIAL; DIAGNOSTIC ERRORS; FEMALE; HUMANS; MALE; MIDDLE AGED; STRONGYLOIDES; STRONGYLOIDIASIS;

EID: 62049084226     PISSN: 00468177     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.humpath.2008.10.008     Document Type: Article

References (33)

1. de Silva S., Saykao P., Kelly H., et al. Chronic Strongyloides stercoralis infection in Laotian immigrants and refugees 7-20 years after resettlement in Australia. Epidemiol Infect 128 (2002) 439-444
2. Gill G.V., and Bell D.R. Strongyloides stercoralis infection in former Far East prisoners of war. Br Med J 2 (1979) 572-574
3. Proctor E.M., Isaac-Renton J.L., Robertson W.B., and Black W.A. Strongyloidiasis in Canadian Far East war veterans. Cmaj 133 (1985) 876-878
4. Suzuki T., Nara N., Miyake S., Eishi Y., Sugiyama E., and Aoki N. Fatal strongyloidiasis latent over 42 years in the antineoplastic chemotherapy of a case with malignant lymphoma. Jpn J Med 28 (1989) 96-99
5. Jongsuksuntigul P., Intapan P.M., Wongsaroj T., et al. Prevalence of Strongyloides stercoralis infection in northeastern Thailand (agar plate culture detection). J Med Assoc Thai 86 (2003) 737-741
6. Zago-Gomes M.P., Aikawa K.F., Perazzio S.F., Goncalves C.S., and Pereira F.E. Prevalence of intestinal nematodes in alcoholic patients. Rev Soc Bras Med Trop 35 (2002) 571-574
7. Genta R.M. Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease. Rev Infect Dis 11 (1989) 755-767
8. Samman M.A., Haque S., and Long J.D. Strongyloidiasis colitis: a case report and review of the literature. J Clin Gastroenterol 28 (1999) 77-80
9. Speare R., Durrheim D., and White S. Fatal strongyloidiasis: lessons from the literature. [Power Point Presentation] [last access on September 20 2008]; Available from: (2003). http://www.ards.com.au/Strongy/14_06_Fatal_Strongyloidiasis_lessons_RS.pdf
10. Berry A.J., Long E.G., Smith J.H., Gourley W.K., and Fine D.P. Chronic relapsing colitis due to Strongyloides stercoralis. Am J Trop Med Hyg 32 (1983) 1289-1293
11. Corsetti M., Basilisco G., Pometta R., Allocca M., and Conte D. Mistaken diagnosis of eosinophilic colitis. Ital J Gastroenterol Hepatol 31 (1999) 607-609
12. de Goede E., Martens M., Van Rooy S., and VanMoerkerke I. A case of systemic strongyloidiasis in an ex-coal miner with idiopathic colitis. Eur J Gastroenterol Hepatol 7 (1995) 807-809
13. Drasin G.F., Moss J.P., and Cheng S.H. Strongyloides stercoralis colitis: findings in four cases. Radiology 126 (1978) 619-621
14. Goh S.K., Chow P.K., Chung A.Y., Tan B.H., and Tan P.H. Strongyloides colitis in a patient with Cushing's syndrome. Gastrointest Endosc 59 (2004) 738-741
15. Gutierrez Y., Bhatia P., Garbadawala S.T., Dobson J.R., Wallace T.M., and Carey T.E. Strongyloides stercoralis eosinophilic granulomatous enterocolitis. Am J Surg Pathol 20 (1996) 603-612
16. Lemos L.B., Qu Z., Laucirica R., and Fred H.L. Hyperinfection syndrome in strongyloidiasis: report of two cases. Ann Diagn Pathol 7 (2003) 87-94
17. Weight S.C., and Barrie W.W. Colonic Strongyloides stercoralis infection masquerading as ulcerative colitis. J R Coll Surg Edinb 42 (1997) 202-203
18. Carp N.Z., Nejman J.H., and Kelly J.J. Strongyloidiasis. An unusual cause of colonic pseudopolyposis and gastrointestinal bleeding. Surg Endosc 1 (1987) 175-177
19. Murphy R.A., Barton G., Pinkas H., and Schaefer R. Severe colitis due to Strongyloides stercoralis in a patient with cutaneous Kaposi's sarcoma. Gastrointest Endosc 37 (1991) 79-82
20. Stoopack P.M., and Raufman J.P. Aphthoid ulceration of the colon in strongyloidiasis. Am J Gastroenterol 86 (1991) 639-642
21. Civantos F., and Robinson M.J. Fatal strongyloidiasis following corticosteroid therapy. Am J Dig Dis 14 (1969) 643-651
22. Powell R.W., Moss J.P., Nagar D., et al. Strongyloidiasis in immunosuppressed hosts. Presentation as massive lower gastrointestinal bleeding. Arch Intern Med 140 (1980) 1061-1063
23. Lemos L.B., Qu Z., Garg K., and Papasozomenos S. Pseudoneoplastic proliferation of histiocytes with paclitaxel-induced ultrastructural changes in a mastectomy specimen. Ann Diagn Pathol 8 (2004) 299-304
24. Pelletier Jr. L.L. Chronic strongyloidiasis in World War II Far East ex-prisoners of war. Am J Trop Med Hyg 33 (1984) 55-61
25. Singthong S., Intapan P.M., Wongsaroji T., and Maleewong W. Randomized comparative trial of two high-dose albendazole regimens for uncomplicated human strongyloidiasis. Southeast Asian J Trop Med Public Health 37 Suppl 3 (2006) 32-34
26. Zaha O., Hirata T., Kinjo F., Saito A., and Fukuhara H. Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart. J Infect Chemother 8 (2002) 94-98
27. Zaha O., Hirata T., Uchima N., Kinjo F., and Saito A. Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody. J Infect Chemother 10 (2004) 348-351
28. Klein R.A., Cleri D.J., Doshi V., and Brasitus T.A. Disseminated Strongyloides stercoralis: a fatal case eluding diagnosis. South Med J 76 (1983) 1438-1440
29. Linder J.D., Monkemuller K.E., Lazenby A.J., and Wilcox C.M. Streptococcus bovis bacteremia associated with Strongyloides stercoralis colitis. Gastrointest Endosc 52 (2000) 796-798
30. Thompson B.F., Fry L.C., Wells C.D., et al. The spectrum of GI strongyloidiasis: an endoscopic-pathologic study. Gastrointest Endosc 59 (2004) 906-910
31. Wong V.W., Leung W.K., To K.F., and Sung J.J. Diarrhoea and rash in a retired farmer. Hong Kong Med J 11 (2005) 397-398
32. Ali-Khan Z., and Seemayer T.A. Fatal bowel infarction and sepsis: an unusual complication of systemic strongyloidiasis. Trans R Soc Trop Med Hyg 69 (1975) 473-476
33. Sathe P.A., and Madiwale C.V. Strongyloidiasis hyperinfection in a patient with membranoproliferative glomerulonephritis. J Postgrad Med 52 (2006) 221-222