Opportunistic Strongyloides Stercoralis Infection in an Immunocompromised Patient.

Strongyloides stercoralis is an intestinal nematode that infects human percutaneously and has a complex life cycle including a direct, an autoinfective and a non-parasitic freeliving developmental cycle. Strongyloidiasis has a worldwide distribution, and usually causes mild or asymptomatic infection. However hyperinfection syndrome can cause significant morbidity and mortality in immunocompromised states such as malignancy, HIV infection, or immunosuppressive agent administration. We report a case of a 37-year old male HIV positive patient admitted in male medical ward, RIMS with severe diarrhoea, pain abdomen, generalized weakness and history of diarrhoea off and on for past one month. His CD4+ T- lymphocyte count was 116 cell/microlitre and the patient was on antiretroviral therapy. Stool examination reveals larvae of Strongyloides stercoralis. Stool culture was negative for pathogenic bacteria and fungi. Special staining for detection of intestinal coccidian parasites and microsporidiosis was also negative .The patient was successfully treated with combined therapy of albendazole(400mg) and ivermectin(6mg) daily for 3days.

Role of imprint cytology in the diagnosis of gastrointestinal tract malignancies.

Endoscopic biopsies obtained from 275 patients (180 from the upper gastrointestinal tract and 95 from the lower gastrointestinal tract) were studied to compare the accuracy of biopsy imprint cytology and histology in the diagnosis of gastrointestinal lesions, and also to establish the degree of reliability of imprint cytology alone for an early diagnosis of malignancy. Biopsy histology results were found to be correct in 100% cases. Imprint cytology had an overall accuracy of 100%, 96.7%, 95.8% and 95.8% for the diagnosis of malignancies of the oesophagus, stomach, duodenum and colorectum respectively. False negative results were obtained with lymphomas. Regenerative cellular atypia was an important cause for false positive results. It was concluded that imprint cytology can serve as a useful and simple tool for an immediate diagnosis of malignancy. This should be subsequently correlated with histopathology which facilitates exact tumour typing and assessment of tumour invasion.