Eosinophilic colitis recrudescence two decades after initial pentastomiasis

Area of Science:

• Parasitology
• Gastroenterology
• Infectious Diseases

Background:

• Visceral pentastomiasis is a rare parasitic infection.
• It can mimic gastrointestinal inflammatory disorders.
• Long latency periods and late recrudescence are possible.

Purpose of the Study:

• To report a case of visceral pentastomiasis presenting as eosinophilic colitis.
• To highlight the potential for long latency and late recrudescence.
• To emphasize considering rare parasitic etiologies in unexplained gastrointestinal diseases.

Main Methods:

• Case report of a Thai female farmer in her early 60s.
• Clinical presentation: recurrent watery diarrhea, peripheral eosinophilia (11%).
• Diagnostic tools: colonoscopy, radiological imaging, histopathology.

Main Results:

• Patient presented with eosinophilic colitis two decades after pulmonary pentastomiasis.
• Colonoscopy revealed multiple submucosal polypoid lesions.
• Histopathology showed eosinophilic infiltration, suggesting recrudescent inflammation from residual parasite material.

Conclusions:

• Visceral pentastomiasis can have extremely long latency periods.
• Late recrudescence can manifest as eosinophilic colitis.
• Rare parasitic etiologies should be considered in unexplained eosinophilic gastrointestinal disease.