A Case of Strongyloides Stercoralis Concurrently Invading the Stomach and Colon

위와 대장을 동시에 침범한 분선충 감염 1예

  • Koh, Eun-Sil (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kang, Sang-Bum (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jeong-Hwa (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Dong-Soo (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Yeon-Soo (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Seung-Woo (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Ahn, Young-Yong (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Heo, Tae-Yun (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • 고은실 (가톨릭대학교 의과대학 내과학교실) ;
  • 강상범 (가톨릭대학교 의과대학 내과학교실) ;
  • 이정화 (가톨릭대학교 의과대학 내과학교실) ;
  • 이동수 (가톨릭대학교 의과대학 내과학교실) ;
  • 김연수 (가톨릭대학교 의과대학 내과학교실) ;
  • 이승우 (가톨릭대학교 의과대학 내과학교실) ;
  • 안영용 (가톨릭대학교 의과대학 내과학교실) ;
  • 허태윤 (가톨릭대학교 의과대학 내과학교실)
  • Received : 2010.01.19
  • Accepted : 2010.05.03
  • Published : 2010.08.30

Abstract

Strongyloides stercoralis is a nematode that may involve any segment of the Gl tract or virtually every human organ because of its autoinfection cycle and hyperinfection. It may occur in either immunocompetent or immunocompromised individuals. A 72-year-old woman who had no notable medical history presented with chronic diarrhea and generalized edema and she revealed protein losing eneteropathy. She was diagnosed with Strongyloidiasis infection through EGD and a colonoscopic biopsy specimen at a time when there were rhabditiform larvae present. The patient was treated with albendazole 400 mg/day for three days. At the follow-up three months later, the endoscopic biopsy specimens revealed no evidence of Strongyloidiasis infection and her clinical symptoms had progressively improved. The present case represents a rare report of Strongyloidiasis in a immunocompetent patient diagnosed through EGD and the colonoscopic biopsy specimen concurrently. So, we report on this case along with a review of the relevant literature.

이번 증례는 기저 질환 및 약물 복용력이 없는 고령의 환자에서 위장관 분선충 감염이 만성 설사와 단백상실성 장관염을 유발한 경우이다. 저자들은 위 내시경 및 대장 내시경을 시행하여 점막 병소들을 발견하고 조직 검사를 시행하여 분선충 유충을 확인하였다. 환자는 3일간 albendazole 400 mg를 투여받은 뒤, 만성 설사 및 저알부민혈증이 호전되었고 3개월 뒤 추적한 위 내시경 및 대장 내시경에서 육안 점막 병소들이 소실되고, 조직 검사에서도 더 이상 분선충은 관찰되지 않았다. 저자들은 내시경 점막 조직 검사를 통하여 위, 대장의 분선충 감염을 동시에 진단한 예를 문헌 고찰과 함께 보고한다.

Keywords

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