Case Report

Successful Ivermectin Treatment of Hepatic Strongyloidiasis Presenting with Severe Eosinophilia

Authors: Zafer Gulbas, MD, Mahmut Kebapci, MD, Ozgul Pasaoglu, MD, Eser Vardareli, MD

Abstract

A 49-year-old, previously healthy nurse presented with hepatic lesions and severe peripheral eosinophilia due to strongyloidiasis. Imaging studies of the abdomen showed predominantly peripheral, confluent hepatic lesions. The hepatic lesions and eosinophilia did not show any improvement with albendazole, but completely resolved with ivermectin treatment. Our findings suggest that Strongyloides stercoralis can present with isolated focal hepatic lesions and severe eosinophilia, and resolves with ivermectin treatment.


Key Points


* Strongyloides stercoralis can present with isolated focal hepatic lesions and severe peripheral eosinophilia.


* The clinical diagnosis of hepatic strongyloidiasis may be delayed because the clinical findings are nonspecific. The presence of eosinophilia warrants a search for this nematode.


* Imaging features are helpful in the diagnosis of hepatic strongyloidiasis.


* Ivermectin is a useful drug for the treatment of hepatic strongyloidiasis.


* Hepatic strongyloidiasis is exceedingly unusual; this case serves to remind physicians that isolated hepatic involvement and eosinophilia are features of strongyloidiasis.

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