Inflammatory bowel disease later diagnosed as strongyloides colitis in migrants to Canada: a case series

Hira Raheel; Swana Kopalakrishnan; Shveta Bhasker; Leila Makhani; Shareese Clarke; Mathew N Nicholas; Asfandyar Mufti; Andrea K Boggild

doi:10.1177/20499361231162719

Inflammatory bowel disease later diagnosed as strongyloides colitis in migrants to Canada: a case series

Ther Adv Infect Dis. 2023 Mar 29:10:20499361231162719. doi: 10.1177/20499361231162719. eCollection 2023 Jan-Dec.

Authors

Hira Raheel¹, Swana Kopalakrishnan¹, Shveta Bhasker², Leila Makhani^{3

4}, Shareese Clarke⁵, Mathew N Nicholas⁶, Asfandyar Mufti⁶, Andrea K Boggild^{7

8

9}

Affiliations

¹ Schulich School of Medicine and Dentistry, London, ON, Canada.
² Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
³ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
⁴ Tropical Disease Unit, Division of Infectious Diseases, UHN-Toronto General Hospital, Toronto, ON, Canada.
⁵ Lawrence S. Bloomberg Faculty of Nursing, Toronto, ON, Canada.
⁶ Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁷ Tropical Disease Unit, Division of Infectious Diseases, UHN-Toronto General Hospital, 200 Elizabeth Street, 13EN-218, Toronto, ON M5G 2C4, Canada.
⁸ Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁹ Institute of Medical Science, University of Toronto, Toronto, ON, Canada.

Abstract

Strongyloides colitis is a gastrointestinal manifestation of the parasitic infection, Strongyloides stercoralis, which may be misdiagnosed and treated as ulcerative colitis (UC) in patients presenting in non-endemic regions. Treatment of Strongyloides colitis as UC can lead to a lethal hyperinfection syndrome. Therefore, prior to commencing immunosuppressive treatment of UC, it is essential to use diagnostic markers to differentiate the two etiologies. In this case series, we discuss two migrant patients who were previously diagnosed with UC and treated accordingly who presented to our clinic for further investigation of suspected parasitic infection.

Keywords: case report; strongyloidiasis; ulcerative colitis.

Publication types

Case Reports