Lethal Strongyloides Stercoralis hyperinfection in a young female with lupus nephritis; a rare case report

Zain Majid, Syed Ahmad, Mehreen Malik Iqbal, Muhammed Mubarak


A young female, known case of lupus nephritis class III, on immunosuppressive drugs, presenting with continuous fever, diarrhea, cough, shortness of breath and hemoptysis. Physical examination revealed a non-healing ulcer on her right ankle with crepitation and wheezes heard bilaterally in her chest. Chest x-ray had bilateral infiltrates suggestive of interstitial lung disease while echocardiography, computerized tomography (CT) scan chest, bronchoalveolar lavage (BAL) and all cultures were negative. Antibiotics were started empirically but her condition did not improve. Later on, a palpable lymph node in the left axillary region was biopsied. In the meantime, the patient's condition had deteriorated and she died before the results of biopsy could be obtained. The lymph node biopsy revealed Strongyloides stercoralis-associated lymphadenitis. Thus, the biopsy resolved the complex clinical presentation of this patient with disseminated S. stercoralis infection.


Core tip
It is a necessity to keep a high index of suspicion for an early diagnosis of disseminated Strongyloides stercoralis infection in patients living in endemic areas for this worm and receiving prolonged immunosuppressive treatment.


Citation: Majid Z, Ahmad S, Iqbal MM, Mubarak MM. Lethal Strongyloides stercoralis hyperinfection in a young female with lupus nephritis; a rare case report. J Prev Epidemiol. 2017;2(2):e02.


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