{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:01:59Z","timestamp":1787029319164,"version":"build-2736575974"},"reference-count":66,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Severe cases of strongyloidiasis are most often associated with multiple causes of immune suppression, such as corticoid treatment and HTLV (human T-lymphotropic virus) coinfection. Diabetes is not traditionally considered a risk factor for the development of severe strongyloidiasis. We report a rare case of autochthonous severe strongyloidiasis in Romania, a European country with a temperate climate. A 71-year-old patient with no prior travel history was admitted with multiple gastrointestinal complaints and recent weight loss. CT (computed tomography) scans indicated duodenal wall thickening, and duodenal endoscopy evidenced mucosal inflammation, ulcerations and partial duodenal obstruction at D4. Microscopic examination of stool samples and biopsy specimens from the gastric and duodenal mucosa revealed an increased larval burden characteristic of Strongyloides stercoralis hyperinfection. Sequential treatment with albendazole and ivermectin achieved parasitological cure and complete recovery. The novelty of our case stems from the scarcity of severe strongyloidiasis cases reported in Europe and especially in Romania, the absence of other risk factors in our patient aside from diabetes, the involvement of the gastric mucosa and the rare presentation as partial duodenal obstruction. This case highlights the importance of considering strongyloidiasis as a differential diagnosis, even in temperate climates where cases are sporadic, in cases in which immune suppression is not evident and in the absence of eosinophilia. The case is presented in the context of the first literature review examining the relationship between severe strongyloidiasis and diabetes, emphasizing diabetes as a possible risk factor for severe strongyloidiasis.<\/jats:p>","DOI":"10.3390\/pathogens12040530","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T03:32:25Z","timestamp":1680060745000},"page":"530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Rare Case of Strongyloides stercoralis Hyperinfection in a Diabetic Patient from Romania\u2014Case Report and Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"given":"Carmen","family":"Costache","sequence":"first","affiliation":[{"name":"Department of Microbiology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Alina","family":"Colosi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6099-4631","authenticated-orcid":false,"given":"Vlad Sever","family":"Neculicioiu","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Ioana","family":"Florian","sequence":"additional","affiliation":[{"name":"Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobe","family":"Petrushev","sequence":"additional","affiliation":[{"name":"Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Vasvari","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5809-1334","authenticated-orcid":false,"given":"Andrada","family":"Seicean","sequence":"additional","affiliation":[{"name":"Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"},{"name":"Department of Gastroenterology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.4269\/ajtmh.12-0596","article-title":"Strongyloidiasis: An Emerging Infectious Disease in China","volume":"88","author":"Wang","year":"2013","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_2","first-page":"316","article-title":"Sur La Maladie Dite Diar-Rh. e de Cochinchine","volume":"83","author":"Normand","year":"1983","journal-title":"C.R. Acad. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1017\/S0031182016001773","article-title":"Strongyloides","volume":"144","author":"Viney","year":"2017","journal-title":"Parasitology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/01.mcg.0000152779.68900.33","article-title":"Intestinal Strongyloidiasis: Recognition, Management, and Determinants of Outcome","volume":"39","author":"Concha","year":"2005","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Page, W., Judd, J.A., and Bradbury, R.S. (2018). The Unique Life Cycle of Strongyloides Stercoralis and Implications for Public Health Action. Trop. Med. Infect. Dis., 3.","DOI":"10.3390\/tropicalmed3020053"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.trstmh.2008.01.020","article-title":"Strongyloides Hyperinfection Syndrome: An Emerging Global Infectious Disease","volume":"102","author":"Marcos","year":"2008","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1111\/j.1469-0691.2006.01443.x","article-title":"Severe Strongyloidiasis in Corticosteroid-Treated Patients","volume":"12","author":"Fardet","year":"2006","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S0065-308X(08)60036-6","article-title":"Human Strongyloidiasis","volume":"38","author":"Grove","year":"1996","journal-title":"Adv. Parasitol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Khieu, V., Srey, S., Sch\u00e4r, F., Muth, S., Marti, H., and Odermatt, P. (2013). Strongyloides Stercoralis Is a Cause of Abdominal Pain, Diarrhea and Urticaria in Rural Cambodia. BMC Res. Notes, 6.","DOI":"10.1186\/1756-0500-6-200"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1017\/S0031182016000834","article-title":"Human Infection with Strongyloides Stercoralis and Other Related Strongyloides Species","volume":"144","author":"Nutman","year":"2017","journal-title":"Parasitology"},{"key":"ref_11","unstructured":"Gonzales, D.J., Chakraborty, R.K., and Climaco, A. (2022). StatPearls, StatPearls Publishing."},{"key":"ref_12","unstructured":"(2023, January 25). CDC Parasites-Strongyloides, Available online: https:\/\/www.cdc.gov\/parasites\/strongyloides\/health_professionals\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S0140-6736(17)31930-X","article-title":"Soil-Transmitted Helminth Infections","volume":"391","author":"Jourdan","year":"2018","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Buonfrate, D., Bisanzio, D., Giorli, G., Odermatt, P., F\u00fcrst, T., Greenaway, C., French, M., Reithinger, R., Gobbi, F., and Montresor, A. (2020). The Global Prevalence of Strongyloides Stercoralis Infection. Pathogens, 9.","DOI":"10.3390\/pathogens9060468"},{"key":"ref_15","unstructured":"(2023, January 01). ECDC Public Health Guidance on Screening and Vaccination for Infectious Diseases in Newly Arrived Migrants within the EU\/EEA. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/Public%20health%20guidance%20on%20screening%20and%20vaccination%20of%20migrants%20in%20the%20EU%20EEA.pdf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/0035-9203(68)90131-4","article-title":"Investigations on the Intensity of the Infection in a Strongyloidiasis Focus. The Coal Culture Method","volume":"62","author":"Dancescu","year":"1968","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1089\/vbz.2010.0178","article-title":"Intestinal Nematode Infections in Romania: An Epidemiological Study and Brief Review of Literature","volume":"11","author":"Neghina","year":"2011","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Tampa, M., Benea, V., Malin Benea, A., Oancea, C., S\u00e2rbu, I., and Georgescu, S.-R. (2013). Acquired Perforating Disorder in a Patient with Strongyloides Stercoralis. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-S1-P79"},{"key":"ref_19","first-page":"367","article-title":"Ascites with Strongyloides Stercoralis in a Patient with Acute Alcoholic Pancreatitis and Liver Cirrhosis","volume":"18","author":"Drug","year":"2009","journal-title":"J. Gastrointestin. Liver. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.3109\/0886022X.2013.810103","article-title":"\u201cSurprise\u201d in the Evolution of Chronic Membranoproliferative Glomerulonephritis Associated with Severe Strongyloidiasis under Corticotherapy: \u201cHygienic Paradox\u201d?","volume":"35","author":"Gluhovschi","year":"2013","journal-title":"Ren. Fail."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ottino, L., Buonfrate, D., Paradies, P., Bisoffi, Z., Antonelli, A., Rossolini, G.M., Gabrielli, S., Bartoloni, A., and Zammarchi, L. (2020). Autochthonous Human and Canine Strongyloides Stercoralis Infection in Europe: Report of a Human Case in An Italian Teen and Systematic Review of the Literature. Pathogens, 9.","DOI":"10.3390\/pathogens9060439"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1093\/trstmh\/trz135","article-title":"Serological Assays for the Diagnosis of Strongyloides Stercoralis Infection: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy","volume":"114","author":"Kalantari","year":"2020","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Buonfrate, D., Requena-Mendez, A., Angheben, A., Cinquini, M., Cruciani, M., Fittipaldo, A., Giorli, G., Gobbi, F., Piubelli, C., and Bisoffi, Z. (2018). Accuracy of Molecular Biology Techniques for the Diagnosis of Strongyloides Stercoralis Infection-A Systematic Review and Meta-Analysis. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006229"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"545.e1","DOI":"10.1016\/j.amjmed.2006.05.072","article-title":"Maltreatment of Strongyloides Infection: Case Series and Worldwide Physicians-in-Training Survey","volume":"120","author":"Boulware","year":"2007","journal-title":"Am. J. Med."},{"key":"ref_25","first-page":"183","article-title":"An Evaluation of the Agar Plate Method for the Detection of Strongyloides Stercoralis in Northern Thailand","volume":"93","author":"Koga","year":"1990","journal-title":"J. Trop. Med. Hyg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1046\/j.1365-3156.2003.01069.x","article-title":"Clinical Presentation and Diagnostic Sensitivity of Laboratory Tests for Strongyloides Stercoralis in Travellers Compared with Immigrants in a Non-Endemic Country","volume":"8","author":"Sudarshi","year":"2003","journal-title":"Trop. Med. Int. Health"},{"key":"ref_27","first-page":"264","article-title":"Strongyloides Serology--Useful for Diagnosis and Management of Strongyloidiasis in Rural Indigenous Populations, but Important Gaps in Knowledge Remain","volume":"4","author":"Speare","year":"2004","journal-title":"Rural Remote Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"967","DOI":"10.4269\/ajtmh.1999.60.967","article-title":"Fluctuations of Larval Excretion in Strongyloides Stercoralis Infection","volume":"60","author":"Uparanukraw","year":"1999","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Requena-M\u00e9ndez, A., Chiodini, P., Bisoffi, Z., Buonfrate, D., Gotuzzo, E., and Mu\u00f1oz, J. (2013). The Laboratory Diagnosis and Follow up of Strongyloidiasis: A Systematic Review. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002002"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Buonfrate, D., Requena-Mendez, A., Angheben, A., Mu\u00f1oz, J., Gobbi, F., Van Den Ende, J., and Bisoffi, Z. (2013). Severe Strongyloidiasis: A Systematic Review of Case Reports. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-78"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s10096-005-0070-2","article-title":"Disseminated Strongyloidiasis: A Retrospective Study of Clinical Course and Outcome","volume":"25","author":"Lam","year":"2006","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s15010-015-0799-1","article-title":"Strongyloides Stercoralis Hyperinfection Syndrome: A Case Series and a Review of the Literature","volume":"43","author":"Geri","year":"2015","journal-title":"Infection"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1749-7922-5-23","article-title":"Duodenal Obstruction\u2013an Unusual Presentation of Strongyloides Stercoralis Enteritis: A Case Report","volume":"5","author":"Cruz","year":"2010","journal-title":"World J. Emerg. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s11686-021-00438-9","article-title":"Is Gastric Involvement by Strongyloides Stercoralis in an Immunocompetent Patient a Common Finding? A Case Report and Review of the Literature","volume":"67","author":"Pecorella","year":"2022","journal-title":"Acta Parasitol."},{"key":"ref_35","unstructured":"(2013). Centers for Disease Control and Prevention (CDC) Transmission of Strongyloides Stercoralis through Transplantation of Solid Organs\u2014Pennsylvania, 2012. MMWR Morb. Mortal. Wkly. Rep., 62, 264\u2013266."},{"key":"ref_36","first-page":"CD007745","article-title":"Ivermectin versus Albendazole or Thiabendazole for Strongyloides Stercoralis Infection","volume":"2016","author":"Gotuzzo","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"645","DOI":"10.4269\/ajtmh.16-0923","article-title":"Evidence-Based Guidelines for Screening and Management of Strongyloidiasis in Non-Endemic Countries","volume":"97","author":"Buonfrate","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s12639-019-01090-x","article-title":"Strongyloides Stercoralis Hyperinfection Syndrome: A Deeper Understanding of a Neglected Disease","volume":"43","author":"Marin","year":"2019","journal-title":"J. Parasit. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1097\/QCO.0b013e3283551dbd","article-title":"Screening, Prevention, and Treatment for Hyperinfection Syndrome and Disseminated Infections Caused by Strongyloides Stercoralis","volume":"25","author":"Mejia","year":"2012","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1128\/CMR.17.1.208-217.2004","article-title":"Strongyloides Stercoralis in the Immunocompromised Population","volume":"17","author":"Keiser","year":"2004","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Almugadam, B.S., Ibrahim, M.K., Liu, Y., Chen, S.-M., Wang, C.-H., Shao, C.-Y., Ren, B.-W., and Tang, L. (2021). Association of Urogenital and Intestinal Parasitic Infections with Type 2 Diabetes Individuals: A Comparative Study. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-020-05629-9"},{"key":"ref_42","first-page":"e00680","article-title":"Intestinal Parasite Infections in Diabetes Mellitus Patients; A Cross-Sectional Study of the Bolgatanga Municipality, Ghana","volume":"11","author":"Sisu","year":"2021","journal-title":"Sci. Afr."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Neculicioiu, V.S., Colosi, I.A., Toc, D.A., Lesan, A., and Costache, C. (2021). When a Ciliate Meets a Flagellate: A Rare Case of Colpoda Spp. and Colpodella Spp. Isolated from the Urine of a Human Patient. Case Report and Brief Review of Literature. Biology, 10.","DOI":"10.3390\/biology10060476"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1093\/trstmh\/try132","article-title":"Is Strongyloides Seropositivity Associated with Diabetes Mellitus? A Retrospective Case-Control Study in an East London NHS Trust","volume":"113","author":"McGuire","year":"2019","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.actatropica.2006.06.006","article-title":"Is There an Association between Positive Strongyloides Stercoralis Serology and Diabetes Mellitus?","volume":"99","author":"Rodrigues","year":"2006","journal-title":"Acta Trop."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Munisankar, S., Rajamanickam, A., Balasubramanian, S., Muthusamy, S., Dolla, C.K., Menon, P.A., Chinnayan, P., Whalen, C., Gumne, P., and Kaur, I. (2022). Seroprevalence of Strongyloides Stercoralis Infection in a South Indian Adult Population. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010561"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.diabres.2015.01.012","article-title":"Does Strongyloides Stercoralis Infection Protect against Type 2 Diabetes in Humans? Evidence from Australian Aboriginal Adults","volume":"107","author":"Hays","year":"2015","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Hays, R., Esterman, A., and McDermott, R. (2015). Type 2 Diabetes Mellitus Is Associated with Strongyloides Stercoralis Treatment Failure in Australian Aboriginals. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003976"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.3748\/wjg.14.1768","article-title":"Endoscopic and Histopathological Study on the Duodenum of Strongyloides Stercoralis Hyperinfection","volume":"14","author":"Kishimoto","year":"2008","journal-title":"World J. Gastroenterol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1111\/imj.13940","article-title":"Fatal Strongyloides Hyperinfection Syndrome in an Immunocompetent Adult with Review of the Literature","volume":"48","author":"Chan","year":"2018","journal-title":"Intern. Med. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/00007611-199901000-00011","article-title":"Exudative Eosinophilic Pleural Effusion Due to Strongyloides Stercoralis in a Diabetic Man","volume":"92","author":"Emad","year":"1999","journal-title":"South. Med. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"bcr2016217911","DOI":"10.1136\/bcr-2016-217911","article-title":"Strongyloides Hyperinfection Syndrome in an Immunocompetent Host Resulting in Bandemia and Death","volume":"2017","author":"Myint","year":"2017","journal-title":"BMJ Case Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"407","DOI":"10.4103\/0255-0857.71854","article-title":"Disseminated Infection with Strongyloides Stercoralis in a Diabetic Patient","volume":"28","author":"Murali","year":"2010","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_54","first-page":"bcr2013200728","article-title":"Shiga Toxin Producing E Coli Bloodstream Infection Secondary to Strongyloides Penetration through Intestinal Mucosa","volume":"2013","author":"Nagpal","year":"2013","journal-title":"BMJ Case Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.gie.2007.11.020","article-title":"Strongyloides Stercoralis Pancolitis in an Immunocompetent Patient","volume":"68","author":"Sridhara","year":"2008","journal-title":"Gastrointest. Endosc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"135","DOI":"10.4103\/2229-5070.105182","article-title":"Hyperinfection of Strongyloides Stercoralis in an Immunocompetent Patient","volume":"2","author":"Tiwari","year":"2012","journal-title":"Trop. Parasitol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s13256-018-1885-7","article-title":"Streptococcus Pyogenes Bacteremia and Toxic Shock Syndrome Related to Strongyloides Stercoralis Hyperinfection: A Case Report","volume":"12","author":"Cohen","year":"2018","journal-title":"J. Med. Case Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.idcr.2017.09.005","article-title":"Strongyloides Hyperinfection Syndrome Causing Fatal Meningitis and Septicemia by Citrobacter Koseri","volume":"10","author":"Reyes","year":"2017","journal-title":"IDCases"},{"key":"ref_59","first-page":"2560719","article-title":"Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease","volume":"2017","author":"Poveda","year":"2017","journal-title":"Case Rep. Pathol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1007\/s00436-017-5389-y","article-title":"Diagnosis of Strongyloides Stercoralis by Morphological Characteristics Combine with Molecular Biological Methods","volume":"116","author":"Wang","year":"2017","journal-title":"Parasitol. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e2165","DOI":"10.14309\/01.ajg.0000870364.57614.5e","article-title":"S3431 Intestinal Strongyloidiasis and Hyperinfection Syndrome in an Immunocompetent Patient","volume":"117","author":"Miranda","year":"2022","journal-title":"Off. J. Am. Coll. Gastroenterol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"337","DOI":"10.4104\/pcrj.2009.00049","article-title":"An Unusual Presentation of Alveolar Hemorrhage","volume":"18","author":"Ferrer","year":"2009","journal-title":"Prim. Care Respir. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e247032","DOI":"10.1136\/bcr-2021-247032","article-title":"Strongyloides Stercoralis Hyperinfection Syndrome with Cerebral Involvement","volume":"15","author":"Pedersen","year":"2022","journal-title":"BMJ Case Rep."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/S0016-5107(95)70077-3","article-title":"Strongyloidiasis: New Endoscopic Findings","volume":"42","author":"Choudhry","year":"1995","journal-title":"Gastrointest. Endosc."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1097\/MEG.0b013e328364b578","article-title":"Determinants of Reactivation of Inapparent Strongyloides Stercoralis Infection in Patients Hospitalized for Unrelated Admitting Diagnosis","volume":"25","author":"Rets","year":"2013","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"71","DOI":"10.5146\/tjpath.2010.00998","article-title":"Gastric Strongyloidiasis in a Diabetic Patient","volume":"26","author":"Turgutalp","year":"2010","journal-title":"Turk. J. Pathol."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/4\/530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:05:46Z","timestamp":1760123146000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/4\/530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,29]]},"references-count":66,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["pathogens12040530"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12040530","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,29]]}}}