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Infestación por Strongyloides stercoralis en una paciente inmunosuprimida, hallazgo de hembra adulta en heces

2007; Universidad de Antioquia; Issue: 33 Linguagem: Espanhol

0121-4004

Zulbey Rivero, Solneumar Salazar, Rafael Villalobos, Ángela Bracho,

Parasites and Host Interactions

La Estrongiloidiasis es una parasitosis intestinal de distribucion mundial, generalmente paucisintomatica que puede producir ocasionalmente cuadros intestinales severos, asi como enteritis invasiva e hiperinfeccion en pacientes inmunosuprimidos e inmunodefici entes. Se presenta el caso de una paciente bajo terapia con Prednisona, transplantada rena l, quien presenta durante dos semanas dolor abdominal epigastrico, tipo urente, sin irrad iacion, acompanado de vomitos, evacuaciones liquidas y dos dias antes del ingreso, fiebre. Se diagnostica mediante examen de heces, infeccion por Strongyloides stercoralis, recibe tratamiento con Albendazol, presentando luego de 6 dias de tratamiento, larvas y huevos del parasito. Se visualizan ademas al microscopio, dos especimenes adultos de aproximadamente 2mm de largo, muy translucidos, compatibles con hembras adultas de S. stercoralis. Es tratada con Ivermectina, mejorando su cuadro clinico, egresando del hospital en buenas c ondiciones generales. Se analiza el inusual hallazgo de hembras partenogeneticas de S. ster coralis en muestra fecal y las condiciones particulares de este caso de Estrongiloidiasis. Title Strongyloides stercoralis infection in immunosupressed patient, finding of female adult in fecal sample. Abstract Strongyloidiasis is a bowel parasitosis of world distribution, usually paucisymptomatic, that can produce severe intestinal illness, as well as invasive enteritis and hyperinfection in immunosupressed and immunodeficient patients. We report the case of a patient under treatment with prednisone, after kidney transplantation. This patient presented for two weeks before admission, epigastric abdominal pain of a burning type, without irratiation, accompanied with vomiting, liquid evacuations and two days before admission, she presented fever. Fecal examination demonstrated Strongyloides stercoralis. After six days of treatment with Albendazole, larvae and eggs of the parasite were present in fecal examinations. Moreover, two adults specimens of 2mm long, very translucent, were seen at microscope, compatible with adult female worms of S. stercoralis. She was treated with Ivermectin, improving her symptoms, and leaving the hospital in good condition. The inusual finding of partenogenetic fe males of S. stercoralis in fecal samples and the particular conditions of this strongyloidiasis case are discussed.