HIPERINFECCIóN POR STRONGYLOIDES EN ANCIANO CON EPOC

the case is presented of an 81-years old man from a rural area who had been a farmer, a coffee harvester 50 years beforehand and a gardener in bogotá for 22 years. he consulted because of abdominal pain having 10 days？ evolution, localized towards the mesogastrium and epigastrium. he was also suffering from dyspnoea and productive cough. background: chronic obstructive pulmonary disease, smoking 25 packets/year, he had received oral prednisone and inhaled beclomethasone on occasions, including during his last hospitalization. physical examination revealed signs of undernourishment, tachycardia, tachypnoea; stertors at the base of the right hemithorax; abdomen: soft, depressible with pain on deep palpation of the epigastrium and right hypochondrium. he was admitted suffering from systemic inflammatory response syndrome (sirs) dueto tachycardia, tachypnoea, 37,600 leukocytosis and 52%-60% eosinophilia, ig e: 180 ui/ ml. strongyloides stercoralis rabditiform larvae appeared in sputum and fecal material. thoracic radiography revealed right pleural leakage; hepatic echography was normal, endoscopy of upper digestive routes revealed gastritis and duodenitis. treatment was started with 200 mg/kg/dose ivermectin with clinical and laboratory follow-up and satisfactory clinical evolution.