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

Abstract

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. 

Keywords: Strongyloides stercoralis, Lymph node biopsy, Lupus nephritis, Immunosuppressive therapy