Strongyloidiasis associated with severe anemia: A case report in Taiwan

Strongyloidiasis is caused by infection with the helminth, Strongyloides stercoralis. The life cycle of S. stercoralis in the host could last decades owing to autoinfection. Most symptoms of strongyloidiasis are nonspecific and may involve the skin, respiratory tract, or gastrointestinal tract. Severe anemia is a less frequently reported symptom of strongyloidiasis. The prevalence of strongyloidiasis is low in Taiwan, and sporadic cases have been previously reported. We present a case of strongyloidiasis in an 82-year-old woman diagnosed by microscopic examination of stool, presenting with severe normocytic anemia. After treatment with the antiparasitic medication, ivermectin, and blood transfusion, her anemia improved. Therefore, parasite infection should be considered in immunosuppressed patients despite atypical laboratory results. Physicians should be aware of the rare incidence of strongyloidiasis in Taiwan and consider it as a possible differential diagnosis for anemia.