Bacteremia, Liver Injury, and Pneumonitis: Strongyloides Unleashed by a Supplement

Published:October 14, 2022DOI:
      A 51-year-old woman presented with 2 weeks of fevers and postprandial abdominal pain. The symptoms began insidiously and were accompanied by nausea, vomiting, headache, and dizziness. Review of systems was also notable for joint pain in her hands and feet for the past year. She had otherwise been well, and had no diarrhea, urinary symptoms, skin complaints, cough, dyspnea, or focal neurologic symptoms. She had hypertension and diabetes and took metformin and lisinopril. She was originally from Mexico but had lived in Houston, Texas for years without traveling. She had no occupational exposures and did not smoke, drink, or use recreational drugs.
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        • Krolewiecki A
        • Nutman TB
        Strongyloidiasis: a neglected tropical disease.
        Infect Dis Clin North Am. 2019; 33: 135-151
        • Barker JA
        Strongyloides hyperinfection presenting as acute respiratory failure and Gram-negative sepsis.
        Yearb Pulmon Dis. 2007; 2007: 315
        • Tariq H
        • Kamal MU
        • Reddy P
        • et al.
        Anemia, intractable vomiting, chronic diarrhea, and syndrome of inappropriate antidiuretic secretion: a diagnostic dilemma: disseminated strongyloidosis in a patient with newly diagnosed HTLV infection-case report and review of literature.
        Medicine (Baltimore). 2017; 96: e9229
        • Weinstein D
        • Lake-Bakaar G
        Strongyloides stercoralis infection presenting with severe malabsorption and arthritis in an immune competent host.
        Internet J Rheumatol. 2005; 2 (Available at:) (Accessed October 23, 2022)
        • Siddiqui AA
        • Berk SL
        • Charles D Ericsson
        • Robert Steffen
        Diagnosis of Strongyloides stercoralis infection.
        Clin Infect Dis. 2001; 33: 1040-1047
        • Woodring JH
        • Halfhill 2nd, H
        • Berger R
        • Reed JC
        • Moser N
        Clinical and imaging features of pulmonary strongyloidiasis.
        South Med J. 1996; 89: 10-19
        • Mora Carpio AL
        • Meseeha M
        Strongyloides stercoralis.
        StatPearls. StatPearls Publishing, Treasure Island, Fla2022 (Available at:) (Accessed October 23, 2022)
        • Bisoffi Z
        • Buonfrate D
        • Sequi M
        • et al.
        Diagnostic accuracy of five serologic tests for Strongyloides stercoralis infection.
        PLoS Negl Trop Dis. 2014; 8: e2640
        • Kantor ED
        • Rehm CD
        • Du M
        • White E
        • Giovannucci EL
        Trends in dietary supplement use among US adults from 1999-2012.
        JAMA. 2016; 316: 1464-1474
        • Dwyer JT
        • Coates PM
        • Smith MJ
        Dietary supplements: regulatory challenges and research resources.
        Nutrients. 2018; 10: 41
        • Wierzejska RE
        Dietary supplements—for whom? The current state of knowledge about the health effects of selected supplement use.
        Int J Environ Res Public Health. 2021; 18: 8897