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Periumbilical Purpura in Disseminated Strongyloidiasis

Robert E. Kalb, MD; Marc E. Grossman, MD
JAMA. 1986;256(9):1170-1171. doi:10.1001/jama.1986.03380090110027.
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STRONGYLOIDES stercoralis, an intestinal nematode commonly known as the human threadworm, affects an estimated 34 million people in the world.1 Chronic infection is often asymptomatic and may persist for many years after the normal host has left an endemic area. Immunocompromised patients may develop a fulminant illness due to a unique process in the life cycle of S stercoralis in which there are dramatic increases in the number of filariform (infective) larvae. The association between disseminated strongyloidiasis and immunosuppression was first noted in 19662-4 and has been well confirmed since then.

We describe a patient with fatal disseminated strongyloidiasis who developed a periumbilical purpuric eruption in which S stercoralis larvae were found on antemortem skin biopsy specimens. We believe this is the first case of widespread skin involvement in disseminated strongyloidiasis.

Report of a Case  A 62-year-old woman was admitted to Columbia Presbyterian Medical Center, New York, because


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