Esophageal Scab Mimicking a Parasite: A Case Report

Area of Science:

• Gastroenterology
• Parasitology
• Molecular Diagnostics

Background:

• Esophageal parasitic helminths are exceptionally rare.
• This case highlights a diagnostic challenge where a foreign body mimicked a parasitic infection.

Observation:

• A 65-year-old man presented with esophageal foreign bodies after choking.
• Gastroscopy revealed two fluke-like foreign bodies in the esophagus.
• Initial examination suggested a parasitic infection, but further analysis revealed a non-parasitic etiology.

Findings:

• Microscopic and pathological examinations of the foreign bodies were inconclusive for parasitic structures.
• Standard anti-helminthic treatment and stool examinations did not confirm parasitic infection.
• DNA sequencing using universal barcoding primers identified the foreign bodies as non-parasitic, with high homology to the human cytochrome c oxidase subunit I gene.

Implications:

• Esophageal scab can present as a foreign body mimicking parasitic helminths.
• Universal barcoding is a valuable tool for identifying foreign bodies, especially when parasitic infection is suspected.
• This case underscores the importance of integrating molecular techniques in diagnosing unusual gastrointestinal presentations.