Annals Case
A 61-year-old Jamaican woman presented with dyspnea and abdominal rash for 2 days, preceded by abdominal pain and vomiting for 2 weeks. She was hypoxic and hypotensive, requiring ventilator and vasopressor support. Computed tomography (CT) of chest, abdomen, and pelvis revealed diffuse ground-glass opacities with patchy infiltrates in the lungs, distended stomach and duodenum, and extensive abdominal wall and left thigh subcutaneous emphysema. An emergency fasciotomy confirmed necrotizing fasciitis. Blood and wound cultures grew Escherichia coli. Esophagogastroduodenoscopy revealed gastric mucosal swelling and denuded duodenal mucosa with subepithelial hemorrhages. Diagnosis: Disseminated strongyloidiasis. 1