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11/26. Severe strongyloidiasis presenting as occult gastro-intestinal tract malignancy.

    A 38-year-old man presented with severe loss of weight, diarrhoea alternating with constipation and blood in the stool. Clinically, colonic malignancy was suspected, but this was not confirmed. Fresh stool contained numerous larvae of strongyloides stercoralis. The patient responded promptly to levamisole, with cessation of symptoms and rapid weight gain.
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ranking = 1
keywords = stercoralis
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12/26. strongyloides stercoralis colitis: findings in four cases.

    The 4 cases of strongyloides stercoralis colitis presented show various radiological manifestations of colonic reaction. Mild involvement may be associated with minimal radiographic changes. Invasion of the bowel wall by the larvae results in ulceration and edema with loss of haustral markings; stricture may develop. barium-enema examinations can help in evaluating the nature and clinical progress of the disease.
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ranking = 5
keywords = stercoralis
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13/26. strongyloides stercoralis.

    strongyloides stercoralis, a nematode not well known to many Canadian physicians, infects 35% of some tropical populations. Larvae can be isolated from the stools in 25% of cases and from duodenal aspirates in 95%. Treatment is with thiabendazole given twice daily in a dose of 25 mg/kg up to a maximum of 1.5 g/d. Frenquently an individual with a previously asymptomatic infection presents with hyperinfection and death rapidly ensues, but usually classical symptoms are present. Such a case is described. immunosuppression is frequently associated with the hyperinfective state.
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ranking = 5
keywords = stercoralis
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14/26. larva currens and systemic disease.

    Of 26 patients infested with strongyloides stercoralis 10 (38.5%) were asymptomatic without systemic or cutaneous signs. Nine patients (34.6%) presented with systemic complaints only and seven patients (26.9%) had systemic and cutaneous manifestations. Further observations of the skin lesions on four of those with systemic and cutaneous manifestations revealed linear urticarial bands, extending to several centimeters within 1 hour and persisting up to many days, waiting and waning. blood examination showed eosinophilia in all patients. These findings confirm the concept that larva currens even alone should be considered a cutaneous sign of systemic disease.
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ranking = 1
keywords = stercoralis
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15/26. Persistent strongyloides stercoralis in a blind loop of the bowel. Successful treatment with mebendazole.

    Three courses of thiabendazole therapy, including one course given directly into a blind loop of the bowel, failed to eradicate strongyloides stercoralis from a 55-year-old man who had undergone a Roux-en-Y operation. The patient responded to 1.5 g/day of mebendazole for 14 days, and the infection did not recur. Our case illustrates the difficulty of eliminating S stercoralis from a blind loop of the bowel and indicates that mebendazole therapy used in adequate doses is effective treatment for strongyloidiasis. The lack of toxicity of mebendazole makes it a desirable drug for Strongyloides infestation resistant to thiabendazole therapy.
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ranking = 6
keywords = stercoralis
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16/26. Radiological manifestations of strongyloides stercoralis.

    Nine patients with radiological changes due to strongyloides stercoralis (SS) are described. A wide variation in appearance exists ranging from mild edema of the duodenal and small bowel mucosa to grossly enlarged, prominent valvulae conniventes. Small bowel dilatation is significant, and in overwhelming infestation toxic dilatation with paresis results. spasm, ulceration, and stricture are encountered in addition. The appearances usually improve and reverse with treatment. Ampullary involvement is responsible for reflux of barium into the pancreatic duct and biliary tree through a patulous sphincter. In 1 patient the colonic changes resembled ulcerative colitis.
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ranking = 5
keywords = stercoralis
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17/26. strongyloidiasis in immunosuppressed hosts. Presentation as massive lower gastrointestinal bleeding.

    Two cases of massive lower gastrointestinal hemorrhage in immunosuppressed patients were due to complicated infestation with strongyloides stercoralis. The very high mortality of disseminated strongyloidiasis may in part be attributed to delays in diagnosis and treatment resulting from the complex life cycle of this nematode. Successful therapy in the cases presented consisted of reduction of corticosteroid dosage, use of thiabendazole in excess of that recommended for uncomplicated infestation, parenterally administered nutrition, multiple transfusion of blood products, and vigorous supportive management. Emphasis is given to proper categorization of patients and measures designed to prevent, detect, and treat hyperinfection in patients in whom immunosuppression is anticipated.
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ranking = 1
keywords = stercoralis
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18/26. Intestinal strongyloidiasis. A case report and review of the literature.

    A patient infected with strongyloides stercoralis presented with hematemesis and abdominal pain mimicking peptic ulcer disease. Radiologic evaluation, however, suggested Crohn's disease of the proximal small intestine. Aspiration of intestinal fluid and a small bowel biopsy lead to a diagnosis of invasive strongyloidiasis. This case is presented and the literature reviewed to demonstrate the protean manifestation of this parasite which commonly involves the gastrointestinal tract.
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ranking = 1
keywords = stercoralis
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19/26. Disseminated strongyloidiasis. diagnosis made by sputum examination.

    Two immune-compromised patients had pulmonary and intestinal infection due to strongyloides stercoralis. diagnosis was facilitated in both cases when the parasites were found in the sputum. Treatment with thiabendazole appeared to eradicate the infection, but repeated follow-up examinations are needed because of the likelihood of relapse.
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ranking = 1
keywords = stercoralis
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20/26. L-dopa malabsorption in a parkinsonian patient with strongyloides stercoralis duodenitis.

    We report a parkinsonian patient initially responding to L-dopa who developed a severe loss of drug efficacy due to strongyloides stercoralis duodenitis. The patient was put on mebendazole and metronidazole, and the parasitosis abated, allowing L-dopa reduction by 33%. Our patient illustrates the advisability of searching for strongyloides stercoralis when L-dopa malabsorption is suspected in Parkinson's disease.
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ranking = 6
keywords = stercoralis
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