Strongyloides hyper-infection causing life-threatening gastrointestinal bleeding

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In hyper-infection syndrome, complete disruption of the GI mucosa, ulcerations, paralytic ileus with exudative enteropathy as well as massive GI bleeding may also occur due to the direct invasion of the larvae. Profound diarrhea, malabsorption with consequent hypo-albuminemia and electrolyte disturbances were all consistent with hyper-infection related enteropathy in our patient. On the other hand, effective anthelminthic treatment in hyper-infected patients can lead to mass-destruction of intraluminal and intramural larvae and to release of huge amounts of different toxic inflammatory and vaso-active compounds[7,8].