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

We present the case of a 33 year-old Italian man who came to our attention for epigastralgia associated with polyserositis (pleural and 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 sierological investigations, a positive antistrongyloides IgG antibodies titre rose suspicions of Strongyloides infection, which was confirmed by positive stool sample for parasite. Ivermectin-therapy was started and the patient’s fully recovered