A Case of Strongyloidiasis Presenting as Ulcerative Colitis

Abstract

Strongyloidiasis disease caused by the Strongyloidesstercoralis nematode .This disease mainly affects the intestines. Sometimes the symptoms were similar to inflammatory bowel disease which may lead to misdiagnosis and lack of effective treatment.

A 46-year-old male patient who complained of occasional diarrhea, sometimes with blood, about two months ago consulted with  an internist. He had colonoscopy and ulcerative colitis was diagnosed without biopsy. The patient was treated with Mesalamine together with Prednisolone. The patient's symptoms improved within the first two weeks, but after the third week got worse and he referred to a gastroenterologist. The patient then underwent colonoscopy and biopsy was done this time.In the biopsy, Strongyloidesstercoralis larvae were observed. Prednisone and Mesalamine were stopped and Ivermectin tablet was administered. Patient's symptoms improved within a week to ten days and one year after treatment patient did not express any complaint.

For diagnosis of ulcerative colitis,In addition to the colonoscopic observations, biopsy is necessary. Especially in the northern regions of the country, before initiating treatment with immunosuppressive and steroid drugs and/or if no response to treatment, it is necessary to think about strangyloidiasis.