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Images of Memorable Cases: Case 35

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk

Case_35-pres1-1.jpg Case_35-pres1-2.jpg

Urine sediment and colonic mucosa from a 53-year-old woman with nonproductive cough, reticulonodular densities on chest radiograph, chronic diarrhea, and recent treatment with large doses of corticosteroids.

35. Disseminated strongyloidiasis

The free-swimming worms in this patient’s urine proved to be larvae of Strongyloides stercoralis. These larvae were also identified in her colonic mucosa (image below, arrows). Although finding larvae in the urine of patients with disseminated strongyloidiasis is rare, it points immediately to the correct diagnosis and prevents what could become a baffling clinical problem with a fatal outcome.

Case_35-diag1-1.jpg

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