Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report

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 a...

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Main Authors: Zhuangheng Lin, Weiming Su, Dinghui Wu, Yangkun Lin, Lijuan Jian, Zigang He, Dandan Jiang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1591707/full
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author Zhuangheng Lin
Weiming Su
Dinghui Wu
Yangkun Lin
Lijuan Jian
Zigang He
Dandan Jiang
author_facet Zhuangheng Lin
Weiming Su
Dinghui Wu
Yangkun Lin
Lijuan Jian
Zigang He
Dandan Jiang
author_sort Zhuangheng Lin
collection DOAJ
description 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.
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spelling doaj-art-9f77dc89adfc41ff88f11995e274c94e2025-08-20T02:46:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15917071591707Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case reportZhuangheng LinWeiming SuDinghui WuYangkun LinLijuan JianZigang HeDandan JiangHerein, 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.https://www.frontiersin.org/articles/10.3389/fmed.2025.1591707/fullStrongyloides stercoralis (S. stercoralis)allergic bronchopulmonary aspergillosis (ABPA)elevated IgEparasitic infectionscase report
spellingShingle Zhuangheng Lin
Weiming Su
Dinghui Wu
Yangkun Lin
Lijuan Jian
Zigang He
Dandan Jiang
Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report
Frontiers in Medicine
Strongyloides stercoralis (S. stercoralis)
allergic bronchopulmonary aspergillosis (ABPA)
elevated IgE
parasitic infections
case report
title Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report
title_full Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report
title_fullStr Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report
title_full_unstemmed Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report
title_short Concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis: case report
title_sort concurrent strongyloidiasis and allergic bronchopulmonary aspergillosis complicating diagnosis case report
topic Strongyloides stercoralis (S. stercoralis)
allergic bronchopulmonary aspergillosis (ABPA)
elevated IgE
parasitic infections
case report
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1591707/full
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