An unusual cause of eosinophilic pleural effusion and migrating biliary stenosis: Strongyloides stercoralis infection in a young immunocompetent man

  • Elisa Paolucci | elisa.paolucci@auslromagna.it Internal Medicine Unit, Bufalini Hospital, Cesena (FC), Italy.
  • Eva Tonveronachi Internal Medicine Unit, Bufalini Hospital, Cesena (FC), Italy.
  • Chiara Praticò Medicina Ospedale S. Orsola-Malpighi, Bologna, Italy.
  • Maria Cristina Zani Internal Medicine Unit, Bufalini Hospital, Cesena (FC), Italy.
  • Maria Cristina Paonessa Internal Medicine Unit, Bufalini Hospital, Cesena (FC), Italy.
  • Michele Maria Domenico Imperatore Internal Medicine Unit, Bufalini Hospital, Cesena (FC), Italy.
  • Beniamino Praticò Internal Medicine Unit, Bufalini Hospital, Cesena (FC), Italy.

Abstract

We present the case of a 33-year-old Italian man who came to our attention for epigastralgia associated with polyserositis (pleural, pericardial, and peritoneal effusion with the involvement of the Douglas excavation), in the absence of a significant medical history. Laboratory analysis revealed exudative eosinophilic pleural effusion; serial imaging techniques showed a transient stenosis of the right hepatic duct and a subsequent stenosis of the left hepatic duct. After several negative serological investigations, a positive anti-strongyloides immunoglobulin G antibodies titer rose suspicions of Strongyloides infection, which was confirmed by positive stool sample for parasite. Ivermectin-therapy was started and the patient has fully recovered.

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Published
2019-02-20
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Section
Case Reports
Keywords:
Pleural effusion, eosinophilia, hepatic duct stenosis, Strongyloides stercoralis, ivermectin.
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How to Cite
Paolucci, E., Tonveronachi, E., Praticò, C., Zani, M. C., Paonessa, M. C., Imperatore, M. M. D., & Praticò, B. (2019). An unusual cause of eosinophilic pleural effusion and migrating biliary stenosis: Strongyloides stercoralis infection in a young immunocompetent man. Italian Journal of Medicine, 13(2), 116-120. https://doi.org/10.4081/itjm.2019.1121