A Case of Duodenal Ulcer Due to Coinfection with Strongyloides stericoralis and Cytomegalovirus

Hyun-Ok Kim; Jae Hee Kim; Yun-Hong Cheon; Young Sun Suh; Min Hee Lim; Sang Taek Heo; Woon Mok Sohn; Gyung Hyuck Ko; In-Gyu Bae

doi:10.3947/ic.2010.42.6.431

Journal List > Infect Chemother > v.42(6) > 1035054

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Kim, Kim, Cheon, Suh, Lim, Heo, Sohn, Ko, and Bae: A Case of Duodenal Ulcer Due to Coinfection with Strongyloides stericoralis and Cytomegalovirus

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(6): 431-433.

Published online: 31 December 2010

DOI: https://doi.org/10.3947/ic.2010.42.6.431

A Case of Duodenal Ulcer Due to Coinfection with Strongyloides stericoralis and Cytomegalovirus

Hyun-Ok Kim^1,⁴, Jae Hee Kim¹, Yun-Hong Cheon¹, Young Sun Suh¹, Min Hee Lim¹, Sang Taek Heo^1,⁴, Woon Mok Sohn^3,⁴, Gyung Hyuck Ko^3,⁴, In-Gyu Bae^1,⁴

¹Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.

²Department of Parasitology, Gyeongsang National University School of Medicine, Jinju, Korea.

³Department of Pathology, Gyeongsang National University School of Medicine, Jinju, Korea.

⁴Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.

Correspondence to In-Gyu Bae, M.D. Department of Internal Medicine, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju 660-702, Korea. Tel: +82-55-750-8055, Fax: +82-55-755-9078, ttezebae@gmail.com

Received 15 July 2010 Revised 13 August 2010 Accepted 24 August 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastrointestinal strongyloidiasis and Cytomegalovirus infection mostly occur in patients receiving cancer chemotherapy, undergoing immunosuppressive therapy after organ transplantation, and suffering from acquired immune deficiency syndrome. A 56-year-old man was admitted to the hospital because of abdominal pain and constipation. He had a 10-year history of chronic obstructive pulmonary disease and has been treated intermittently with systemic steroid. The gastroduodenoscopic examination showed a single ulcer on the duodenal bulb and microscopic finding of the biopsy specimens from the ulcer revealed Strongyloides stercoralis and cytomegalovirus immunohistochemical stain positive intranuclear inclusion body on the mucosal surface. The patient was successfully treated with albendazole and ganciclovir.

Keywords: Strongyloides stercoralis, Cytomegalovirus, Duodenal ulcer, Steroids

Figures and Tables

Figure 1

Microscopic appearance of Strongyloides stercoralis from duodenal biopsy specimen. A filariform larva (arrow) is seen in the lumen of an intestinal gland (H&E stain, ×200).

Figure 2

Microscopic appearance of an intranuclear inclusion body from duodenal biopsy specimen. Several glandular epithelial cells (arrow) are enlarged and protrude into the glandular lumen. The nuclei of the cells contain large amphophilic viral inclusions (H&E stain, ×200).

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