Early-onset polyarthritis as presenting feature of intestinal infection with Strongyloides stercoralis

SIR, In a patient with symmetrical polyarthritis the diagnosisof rheumatoid arthritis (RA) is advocated, especially if nosigns of (recent) infection are present. It is considered goodclinical practice nowadays to start early treatment with anti-rheumaticdrugs, including corticosteroids or tumour necrosis factor-(TNF-)-blocking agents. To prevent a life-threatening outcome,however, some rare infections have to be excluded. We describea patient who presented with recent-onset symmetrical polyarthritisand infection with Strongyloides stercoralis. A 35-yr-old male was referred to our