Abstract

Strongyloides stercoralis is an intestinal nematode with both free-living and parasitic stages and is common in the tropics. Chronic infection may lead to cutaneous, gastrointestinal, or pulmonary symptoms. We present the case of a 40-year-old male farmer, with on and off loose motions, productive cough, and loss of weight and was admitted with the provisional diagnosis of pulmonary tuberculosis. Rhabditiform larva of S. stercoralis was discovered in the sputum which was sent for screening of acid-fast bacilli. Stool examination was not done. There was no history suggestive of immunocompromised status and the screening test for HIV antibody was negative. Sputum culture showed growth of Escherichia coli. Other laboratory parameters were within normal limits. His chest X-ray revealed bilateral diffuse infiltrates. He was thereby diagnosed to be a case of pulmonary strongyloidiasis, but his condition deteriorated, and he expired before institution of any treatment. Although a potentially lethal opportunistic infection, strongyloidiasis is amenable to treatment with anthelmintics if detected in time. Hence, clinical suspicion with timely diagnosis and aggressive treatment becomes mandatory.