Strongyloides Infection in a Man with Abdominal Pain and a History of Rheumatoid Arthritis

Fariborz Mansour-Ghanaei1, Farahnaz Joukar2, *, Alireza Samadi1, Sara Mavaddati1, Arash Daryakar1
1 Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
2 Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran

© 2018 Mansour-Ghanaei et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Caspian Digestive Diseases Research Center CDDRC, Guilan University of Medical Sciences GUMS, Razi Hospital, Sardar-Jangle Ave., P.O. Box: 41448-95655, Rasht, Iran; Tel: +981333534951; Fax: +981333535116; E-mail:



Strongyloidiasis is self-limited by the complete immune system, it may be complicated and causes hyperinfection in immunocompromised patients. Objective: Here, we report a case of an immunocompromised patient with duodenal involvement of Strongyloides stercoralis.

Case Report:

A 65-year-old man presented with severe pain in central abdomen and periumbilical regions. He had no history of alcohol consumption, smoking and surgery but the history of RA (Rheumatoid Arthritis) and hypothyroidism taking immunosuppressive medications. The patient underwent endoscopy and colonoscopy which pathological analysis of the biopsies revealed remarkable findings in favor of Strongyloidiasis. After two consecutive day’s consumption of ivermectin 200µg/kg, the symptoms were completely removed. Also, the stool examination was negative for S. stercoralis larvae two weeks after end of the treatment.


It seems that in immunocompromised patients with gastrointestinal symptoms assumption of parasite-like infections such as Strongyloidiasis should be considered as one of the diagnosis options. Due to the physiological and gut microbial alternations, these patients are more susceptible to infectious diseases.

Keywords: Colonoscopy, Gut microbiome, Hyperinfection, Ivermectin, Rheumatoid arthritis, Strongyloides stercoralis.