CTICasesRecurrent Strongyloides Infection (Migratory Eosinophilic Pneumonia)
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Imaging findings
Over a span of several years, serial CT scans show fluctuating and migratory pulmonary infiltrates. Initially, nondescript patchy ground-glass consolidation in the right upper lobe is seen, followed by new areas of consolidation while previous ones improve. The disease progresses to multiple bilateral nodular foci of consolidation and ground glass with a peripheral and random distribution, interspersed with periods of significant improvement.
Key takeaways
Strongyloides stercoralis infection can present as recurrent, migratory pulmonary infiltrates (often termed 'fleeting infiltrates' or migratory eosinophilic pneumonia) associated with chronic eosinophilia. Unlike other worms, Strongyloides can complete its life cycle entirely within the human host (between the small bowel and lungs), leading to persistent or recurrent infection for decades, even without a hyperinfection syndrome. This chronic autoinfection can be mistaken for recurrent eosinophilic pneumonia.
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