Chylous Ascites as the Main Clinical Symptom of a Strongyloides stercoralis Infection in an Immigrant from Bosnia-Herzegovina
  • Lukas Antonitsch
    Internal Medicine I, Gastroenterology and Nephrology – Hospital of the Brothers of St. John of God Vienna, Vienna, Austria; Internal Medicine I, Gastroenterology, Hepatology and Diabetology – Regional Hospital Wiener Neustadt, Wiener Neustadt, Austria
  • Daniela Penz
    Internal Medicine I, Gastroenterology and Nephrology – Hospital of the Brothers of St. John of God Vienna, Vienna, Austria
  • Arnulf Ferlitsch
    Internal Medicine I, Gastroenterology and Nephrology – Hospital of the Brothers of St. John of God Vienna, Vienna, Austria

Keywords

Strongyloidiasis, immigration, Chylous ascites, ivermectin, Strongyloides stercoralis

Abstract

Extraintestinal strongyloidiasis is rare in patients without immunosuppression. We describe the first case of chylous ascites as a result of strongyloidiasis. Alcohol cessation, diuretic therapy and repeated paracentesis did not lead to improvement of refractory chylous ascites with positive nucleic acid amplification test indicative of Strongyloides stercoralis infection. Only after therapy with ivermectin, could diuretics be withdrawn.

Although direct proof of S. stercoralis was not possible by microscopy, successfully treated strongyloidiasis was confirmed in this patient by the positive and negative nucleic acid amplification tests from ascites before and after treatment together with the clinical improvement only after antiparasitic therapy.

VIEW THE ENTIRE ARTICLE

References

  • Nutman, TB. Human infection with Strongyloides stercoralis and other related Strongyloides species. Parasitology 2017;144:263-273.
  • Asdamongkol N, Pornsuriyasak P, Sungkanuparph S. Risk factors for strongyloidiasis hyperinfection and clinical outcomes. Southeast Asian J Trop Med Public Health 2006;37:875-84.
  • Drug V, Haliga R, Akbar Q, Mihai C, Preipcean CC, Stanciu C. Ascites with Strongyloides stercoralis in a patient with acute alcoholic pancreatitis and liver cirrhosis. J Gastrointestin Liver Dis 2009;18:367-9.
  • Bhardwaj R, Vaziri H, Gautam A, Ballesteros E, Karimeddini D, Wu GY. Chylous ascites: a review of pathogenesis, diagnosis and treatment. J Clin Transl Hepatol 2018;6:105-113.
  • Zaha O, Hirata T, Kinjo F, Saito A, Fukuhara H. Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart. J Infect Chemother 2002;8:94-8.
  • Keystone JS. Can one afford not to screen for parasites in high-risk immigrant populations? Clin Infect Dis 2007;45:1316-8.
  • Views: 340
    HTML downloads: 61
    PDF downloads: 206


    Published: 2022-11-04
    Issue: 2022: Vol 9 No 11 (view)


    How to cite:
    1.
    Antonitsch L, Penz D, Ferlitsch A. Chylous Ascites as the Main Clinical Symptom of a Strongyloides stercoralis Infection in an Immigrant from Bosnia-Herzegovina. EJCRIM 2022;9 doi:10.12890/2022_003603.