Eosinophilic ascites secondary to toxocariasis

Eosinophilic ascites is a very rare disorder. It can be a manifestation of the eosinophilic gastroenteritis in its serosal form or it can be secondary to infections, malignancies, vasculitis or hypereosinophilic syndrome. Among all infections, the ones produced by invasive helminth parasites should be initially suspected and ruled out. We report the case of a patient with eosinophilic ascites associated with diarrhea, abdominal pain and eosinophilia in peripheral blood. Eosinophilic colitis was also demonstrated in a colonic biopsy and empirical steroid treatment was started for suspected eosinophilic gastroenteritis. Later on, the patient improved; the ascites disappeared and the eosinophil blood count returned to normal. Subsequently, serologic testing for toxocariasis was received positive and therefore, the diagnosis of eosinophilic gastroenteritis was discarded; albendazole was also added to treatment. The patient remained asymptomatic on follow-up. We emphasize the need to rule out parasitic infections in all patients with gastrointestinal symptoms, eosinophilia and eosinophilic infiltration of gastrointestinal tissues.