Intestinal ileus secondary to Strongyloides stercoralis infection: case report and review of the literature.

Strongyloides stercoralis is an intestinal nematode that is widely distributed throughout the tropics and subtropics. Immigration patterns, travel, and poor hygiene can place patients in the United States at an increased risk. Endemic regions in the southeastern United States have been identified. The infected host may be asymptomatic or present with a wide variety of complaints. Abdominal findings may mimic an acute abdomen or intestinal obstruction, which may lead to an avoidable laparotomy. A massive infection of the gastrointestinal tract and lungs is termed hyperinfection syndrome. Disseminated strongyloides occurs when other organs are involved. This can be life-threatening. A prominent predisposing factor to severe infection is a patient's status as an immunocomprised host. Asymptomatic infected hosts can become symptomatic after the initiation of corticosteroid therapy or other immunosuppressive medications. Strongyloidiasis should be considered in patients with transient pulmonary infiltrates and gastrointestinal complaints. A recent travel history, poor hygiene, cutaneous manifestations, or blood eosinophilia may point to the diagnosis. Negative stool cultures do not rule out the diagnosis, and esphogogastroduodonoscopy with aspiration cultures and mucosal biopsy greatly increase the diagnostic yield. A high index of suspicion is necessary to establish the diagnosis, and unnecessary laparotomies can be avoided.