Strongyloides Infection Masquerading as Gastric Malignancy 2612

• Published in: The American journal of gastroenterology Vol. 113; no. Supplement; p. S1452
• Main Authors: Koya, Nisha, Mikityanskiy, Yevgeniy, Platsky, Vera, Chang, Chunghun, Trillo, John W.
• Format: Journal Article
• Language: English
• Published: New York Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.10.2018
• Subjects: Abdomen
• ISSN: 0002-9270; 1572-0241
• DOI: 10.14309/00000434-201810001-02611

A 49-year-old Haitian man with hypertension and diabetes mellitus presented with a one year history of abdominal pain, 20 ib unintentional weight loss, fatigue, and myalgias. Physical exam revealed a thin man with a soft abdomen and tenderness in the epigastrium. Laboratory testing showed leukocytosis, hemoglobin of 8 with a normal MCV and unremarkable liver chemistries. Computed tomography of the abdomen showed wall thickening in the antrum of the stomach. On esophagogastroduodenoscopy, a hard, ulcerated gastric mass was found in the antrum. Initial biopsy showed ulcerative active gastritis, but no malignant cells. Repeat endoscopy with deep biopsies again failed to confirm a gastric malignancy. Due to ongoing suspicion for cancer, the specimens were sent to another facility for review. Pathology revealed active gastritis with necrotizing inflammatory exudate as well as the presence of organisms resembling Strongyloides. There was no evidence of malignancy. The patient was treated with Ivermectin and had an unremarkable hospital course thereafter including a normal colonoscopy. However, two months after discharge, he returned with intractable diarrhea.