STRONGYLOIDES STERCORALIS: A RARE CASE DIAGNOSED WITH ESOPHAGEAL SWAB SAMPLE

Öz

Strongyloides stercoralis is an opportunistic parasite that may cause severe and fatal disease in immunocompromised hosts. A 70-year-old man with a nonspecific history except pneumoconiosis had diffuse ulcers on the esophagus. Hence, only a swab sample could be performed. On microscopic examination of the swab sample, larvae and soils were observed in necrotic and inflammatory background. It was evaluated as compatible with S. stercoralis. At repeated endoscopic examination multiple biopsies were taken from the stomach. Larvae and soils were detected in crypt lumens with chronic inflammation in gastric mucosa. We presented this case with gastric involvement as a rare presentation that has not been reported in the literature before and was diagnosed by esophageal swab sample. Although infection is usually asymptomatic in the chronic phase, it carries a high mortality risk in immunocompromised hosts. So, it is important to scan the risk group. Swab sampling is an easy method for cytological examination.

Anahtar Kelimeler

• Strongyloides stercoralis
• swab sample
• esophagus
• immunocompromised

Strongyloides Stercoralis: Özofageal Sürüntü Örneği Sitolojisi ile Tanı Alan Nadir Bir Olgu

Öz

Strongyloides stercoralis immün sistemi baskılanmış bireylerde şiddetli ve ölümcül hastalık tablosu oluşturabilen fırsatçı bir parazittir. Pnömokonyoz dışında bilinen spesifik öyküsü olmayan 70 yaşında erkek hastanın endoskopik muayenesinde özofagusta diffüz ülser saptandı. Bu nedenle lezyonlardan sadece sürüntü örneği alınabildi. Sürüntü örneğinin mikroskobik incelemesinde nekrotik ve inflamatuar zeminde izlenen larva ve yumurta yapıları S stercoralis ile uyumlu olarak değerlendirildi. Tekrarlanan endoskopide mideden biyopsiler alındı. Biyopsi örneklerinde gastrik mukozada kronik inflamasyon ile kript lümenlerinde S.stercoralis larvaları ve yumurtaları gözlendi. Biz de literatürde daha önce bildirilmemiş ve özofageal sürüntü yayma ile tanı verilmiş nadir bir prezentasyon olarak mide tutulumu olan bu olguyu sunduk. S. stercoralis kronik dönemde asemptomatik olmakla birlikte, immünkompromize bireylerde infeksiyon yüksek mortalite riski taşır. Bu nedenle risk gruplarının taranması önemlidir. Sürüntü örneklemesi sitolojik inceleme için kolay bir yöntemdir.

Anahtar Kelimeler

• Stronyloides stercoralis
• sürüntü örneği
• özofagus
• immümkompromize

Kaynakça

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