COMMUNITY CASE STUDY article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1591707
Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report
Provisionally accepted- Department of Neurology, First Affiliated Hospital of Xiamen University, Xiamen, China
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Herein, we report a case of allergic bronchopulmonary aspergillosis (ABPA) complicated by Strongyloides stercoralis infection. A 73-year-old man with a history of duodenal ulcer perforation and prior Billroth II gastrectomy presented with a 14-year history of recurrent cough and wheezing, recently accompanied by new gastrointestinal symptoms. He was initially diagnosed with chronic obstructive pulmonary disease (COPD). Subsequent laboratory evaluation revealed a markedly elevated total serum IgE (1,219 kUA/L) and increased Aspergillus fumigatus-specific IgE (0.38 kUA/L, positive cutoff >0.35 kUA/L), leading to a diagnosis of ABPA. Despite antifungal and corticosteroid therapy, total IgE levels remained persistently elevated, accompanied by worsening gastrointestinal symptoms. Multiple stool examinations failed to detect parasitic infection. As gastrointestinal symptoms progressed, gastroscopy revealed the presence of parasitic eggs and larvae. Subsequently, a stool specimen was sent to the Xiamen Center for Disease Control and Prevention. Using the formol-ether concentration technique, the microscopic examination ultimately confirmed an infection with Strongyloides stercoralis. Following albendazole treatment, the patient ' s symptoms completely resolved.In conclusion, co-infection of ABPA with Strongyloides stercoralis may lead to missed or delayed diagnosis due to persistently elevated IgE levels.Strongyloides stercoralis is a soil-transmitted nematode predominantly endemic to tropical and subtropical regions with poor sanitary conditions, affecting an estimated 600 million individuals globally-primarily within rural populations [1] . Most infections are asymptomatic or present with only mild symptoms; however, in immunocompromised hosts, the disease can progress to severe forms such as hyperinfection or disseminated strongyloidiasis, both associated with high mortality rates [2-4] . Diagnosis of this helminth relies on clinical suspicion, stool examination, and serologic testing; nevertheless, the diagnostic yield is often limited by the variable clinical presentations and the intermittent nature of larval shedding, leading to a substantial risk of missed diagnoses [5-7] . Allergic bronchopulmonary aspergillosis (ABPA) is a complex
Keywords: Strongyloides stercoralis (S. stercoralis), Allergic bronchopulmonary aspergillosis (ABPA), Elevated IgE, Parasitic infections, case report
Received: 11 Mar 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Lin, Lin, Su and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhuangheng Lin, Department of Neurology, First Affiliated Hospital of Xiamen University, Xiamen, China
Zhuangheng Lin, Department of Neurology, First Affiliated Hospital of Xiamen University, Xiamen, China
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