The Cryptic Infection by Strongyloides stercoralis and Helicobacter pylori Mimicking Malignancy: A Case Report

Abstract

Aim: The aim of this case report is to emphasize on the importance of keeping parasitic infections as a differential diagnosis in cases clinically suspicious for gastrointestinal malignancies. Case Presentation: We report a case of 60-year-old male with a co-infection by Strongyloides stercoralis and Helicobacter pylori. The patient presented with the non-specific symptoms of epigastric discomfort, fatigue and unintentional weight loss over several months with no significant past medical history. This led to a suspicion of malignancy for which routine investigations along with upper gastrointestinal endoscopy with biopsy were performed. Subsequently, rhabditiform larvae of Strongyloides stercoralis and Helicobacter pylori were identified on gastric and duodenal biopsies. Discussion: Strongyloidiasis is a parasitic infection caused by Strongyloides stercoralis; common in tropical and sub-tropical areas infecting about 600 million individuals globally. It usually targets immune-compromised hosts owing to hyper infestation but remains asymptomatic in healthy individuals usually. Moreover, there is limited availability of diagnostic modalities for such parasitic infections that hinders the way for early diagnosis, therefore leading to poor prognosis. Conclusion: Due to the non-specific nature of the symptoms, it is difficult to reach the diagnosis though it is necessary to have a high degree of suspicion and make an early diagnosis in order to have better outcomes.