Case 23-2012: A Man with Abdominal Pain and Weight Loss

New England Journal of Medicine (Impact Factor: 55.87). 10/2012; 367(17):1670; author reply 1671-2. DOI: 10.1056/NEJMc1210168#SA1
Source: PubMed


To the Editor: With regard to the Case Record by Xavier et al. (July 26 issue),(1) which discusses the diagnosis of strongyloidiasis: I am concerned about proceeding with upper and lower gastrointestinal endoscopic investigations after identifying numerous rhabditiform larvae of Strongyloides stercoralis in a stool specimen obtained from a patient. On the basis of the typical clinical manifestations that are compatible with strongyloidiasis,(2) such patients could receive ivermectin as the treatment of choice for this potentially fatal parasitic infection. Endoscopic procedures could cause complications, including perforation and toxic megacolon, and they are unlikely to alter therapeutic decision making. To the . . .

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