Ulcerative Colitis/Stercoralis Infection

Main Category: GastroIntestinal / Gastroenterology
Also Included In: Headache / Migraine;  Tropical Diseases
Article Date: 24 Sep 2008 - 10:00 PDT

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Although exacerbation of UC usually poses little diagnostic dilemma, physicians should remain cognizant to the possibility of an alternative cause for patient symptoms.

An article published in the World Journal of Gastroenterology addresses this report. The research team led by Prof. Ben-Horin from the Gastroenterology department of Sheba Medical Center in Israel described a 54-year-old patient with long standing ulcerative colitis who experienced fever, diarrhea and abdominal pain 2 weeks after receiving corticosteroids as a treatment for severe cluster headaches.

After empiric antibiotics proved ineffective, the patient underwent upper and lower endoscopic studies. Biopsies obtained from the inflamed duodenal mucosa showed evidence of infection with the nematode Strongyloides stercoralis. This parasite is only found in certain tropic and sub-tropic areas of the world, but not in Israel. Thus, it was most likely acquired by the patient 20 years earlier, when he was residing in Brazil, and remained dormant until steroid treatment has weakened the patient immune resistance to this infection.

The patient made a complete recovery following appropriate treatment with an anti-parasitic drug. The researchers note that this patient's case underscores the need to exclude even rare parasitic infections that may mimic a flare-up of ulcerative colitis.

This is especially important before increasing immuno-suppression, since inhibition of the immune system by these drugs facilitates further dissemination of Strongyloides parasites and can result in a fatal infection.

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Reference: Ben-Horin S, Barshack I, Chowers Y, Mouallem M. Flare-up of ulcerative colitis after systemic corticosteroids - A strong case for Strongyloides. World J Gastroenterol 2008;14(27): 4413-4415 http://www.wjgnet.com/1007-9327/14/4413.asp

Correspondence to: Dr. Shomron Ben-Horin, Gastroenterology Department, Sheba Medical Center, Tel-Hashomer 52621, Israel.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

Source: Lai-Fu Li
World Journal of Gastroenterology

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