SHM Converge Scientific Abstract ePoster Gallery-Beyond Usual Suspects: Strongyloides Stercoralis in Pyogenic Liver Abscess Formation

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This case report describes an unusual presentation of <strong>Strongyloides stercoralis</strong> infection associated with <strong>multiple pyogenic liver abscesses</strong> caused by the atypical organism <strong>Streptococcus constellatus</strong>. The patient initially presented with nonspecific gastrointestinal symptoms, leading to a broad differential diagnosis that included <strong>colon cancer</strong> and <strong>inflammatory bowel disease (IBD)</strong>. Imaging showed multiple enlarged hepatic abscesses, and biopsy demonstrated <strong>granulomatous inflammation</strong>, which, together with the patient’s <strong>travel history to an endemic area</strong>, prompted testing for strongyloidiasis.

The report emphasizes that <strong>Strongyloides</strong> is frequently underdiagnosed because chronic infection can mimic common GI disorders such as <strong>IBD, diverticulitis, and colitis</strong>. In this case, the combination of epidemiologic exposure, chronic symptoms, and atypical gram-negative/enteric infection led to the correct diagnosis. After treatment, follow-up imaging showed improvement, with the hepatic abscesses no longer visualized and evidence of residual scarring/fatty change.

The discussion highlights the importance of maintaining a high index of suspicion for strongyloidiasis in patients with unexplained gastrointestinal complaints, especially when there is a history of travel or residence in endemic regions. It also notes that missed diagnosis can have serious or even fatal consequences, particularly in immunocompromised patients or those with disseminated disease.

Overall, this case underscores the need for a <strong>comprehensive diagnostic approach</strong> in patients with atypical infections and liver abscesses, and it adds to the limited literature suggesting that strongyloidiasis may play an underrecognized role in such presentations.

Asset Subtitle

Astitva Soni

Meta Tag

Author List Astitva Soni, Niraj Mehta

Category Clinical Vignettes

Concept Strongyloides Infection

Concept Severe systemic infection

Concept Pyogenic Hepatic Abscess

Concept Gastrointestinal illness

Concept Immunocompromised State

Distinguished Non-Finalist

Presenter Organization Baylor College of Medicine

Presenting Author Astitva Soni

Track Adult

Keywords

Strongyloides stercoralis

pyogenic liver abscess

Streptococcus constellatus

granulomatous inflammation

strongyloidiasis

gastrointestinal symptoms

inflammatory bowel disease

colon cancer differential

endemic travel history

atypical infection

Strongyloides Infection

Severe systemic infection

Pyogenic Hepatic Abscess

Gastrointestinal illness

Immunocompromised State