AN OVERWHELMING STRONGYLOIDES INFECTION

Abstract

Although infections with Strongyloides stercoralis are usually mild, they can be severe1and sometimes fatal.2The patient reported in this paper is of interest for several reasons. First, she had a massive Strongyloides infection, complicated by a terminal Escherichia coli septicemia and meningitis. Second, there was a lag of at least 36 years between the time of first infection with the parasite and the appearance of severe symptoms. Third, at autopsy, there was evidence of an overwhelming internal autoinfection. Obviously, the disease must have been present for many years in a subclinical state. The intensification of her infection followed several abdominal operative procedures, but there must have been other less obvious factors also responsible for the development of the severe autoinfection. It will be recalled that the life cycle of this parasite usually involves the passage of rhabditiform larvae in the stool. These mature outside the body into