Disseminated strongyloidiasis in a patient with rheumatoid arthritis: A case report

Background: Strongyloidiasis is usually a chronic infection but it can develop into a fatal disease in immunosuppressed patients.

Case summary: A 68-year-old male with rheumatoid arthritis was treated with a variety of immunosuppressants for the past 3 years. Recently, the patient presented with a partial small-bowel obstruction, petechia, coughing and peripheral neuropathy. The diagnosis was difficult to clarify in other hospitals. Our hospital found Strongyloides stercoralis larvae with active movement in the routine stool and sputum smears. The diagnosis of disseminated strongyloidiasis was established. Ivermectin combined with albendazole was used for treatment. The patient responded to therapy and was discharged.

Conclusion: This case underscores the importance of comprehensive differential diagnosis in immunocompromised patients.