The true prevalence of S. stercoralis is likely underestimated because infection is often subclinical [1–3]. Currently, an

estimated 100 million people are infected worldwide in more than 70 countries. Strongyloidiasis is endemic in Southeast Asia, Latin America, Sub-Saharan Africa, and parts of the southeastern United States [3–6]. Typically, the infection is www.selleckchem.com/products/CP-673451.html asymptomatic or manifest as vague and unspecific gastrointestinal symptoms. However, disseminated infestation of infective larvae is associated with high mortality rates in immunocompromised patients [3, 7]. Intestinal obstruction is a poorly recognized OICR-9429 order and probably underreported complication of strongyloidiasis. Herein, we report an unusual case, of complete duodenal obstruction caused by S. stercoralis. Additionally, we performed a systematic review of the literature examining the clinical course, diagnostic methods, management and outcome of this rare, but potential fatal complication of S. stercoralis infection. Methods A review of literature was performed using the MEDLINE database in order to identify articles of duodenal obstruction caused by Strongyloides stercolaris. Inclusion was limited to cases reported in adults, and published in the English language since 1970. All the articles

were systematically reviewed and only cases of confirmed duodenal obstruction were included in this report. Case presentation A 42-year-old woman presented Atezolizumab in vivo with a 5-month history of recurrent abdominal pain, nausea, post-prandial vomiting, intermittent diarrhea, and a 20 Kg (44 lb) weight loss. Her past medical history was unremarkable, except for an admission www.selleckchem.com/products/INCB18424.html for pneumonia in the past year. On physical examination the patient was in poor clinical condition, malnourished, afebrile, with a blood pressure of 100/40 mmHg, pulse of 100 beats per minute and a respiratory rate of 24 breaths per minute. No lymphadenophaty was found. The lungs were clear and the heart was normal on auscultation. Abdominal examination revealed epigastric distention, without guarding or rebound

tenderness. The spleen and liver were not palpated and a mild pedal edema was observed. Stools tested for occult blood were positive, and negative for ova and parasites. Laboratory evaluation revealed a hematocrit of 39%, white blood cell count of 14.9 × 103/L (bands 8%, neutrophils 73%, lynphocytes 12%, and eosinophils 0%), and platelet count of 600 × 103/μL. Total serum protein and albumin levels were 2.9 g/dL and 1.2 g/dL, respectively. Serum creatinine was 2.5 mg/dL, BUN 118 mg/dL, and potassium 2.8 mMol/L. Liver function tests, amylase and lipase were within normal limits. She had a positive serology for toxoplasmosis (IgM antibody), but negative for HIV, and HTLV-1. A central line was established and fluid replacement was started. Broad-spectrum antibiotics were initiated for a possible intraabdominal infection/sepsis.