Q: 44 years old male, a recently migrant from southeast Asia is admitted to ICU with gastrointestinal (GI) symptoms including pain and lower GI bleed. Subsequent workup led to the presumed diagnosis of strongyloidiasis. Colonoscopy is performed to rule out ulcerative colitis. Which features distinguish strongyloidiasis from ulcerative colitis?
Answer:Strongyloides colitis can mimic ulcerative colitis. Although endoscopies are not routinely performed in strongyloidiasis but may require ruling out other potentially life-threatening conditions. Strongyloides colitis can be differentiated from ulcerative colitis by noticing skip pattern of inflammation, distal attenuation of the disease, eosinophil-rich infiltrates, relatively intact crypt architecture, and frequent involvement of submucosa with erythematous nodules.