Parasitic Persistence: The Diagnostic Challenge of Strongyloidiasis in a Nonendemic Setting

Strongyloidiasis is a parasitic infection endemic to warm and moist climates, which is caused by the intestinal nematode Strongyloides stercoralis. In the United States, most cases are seen in immunocompromised patients residing in the Northeast and East South-Central regions and in travelers from endemic regions. While often underrecognized, Strongyloides infection should remain a key consideration in patients presenting with atypical gastrointestinal symptoms, with a relevant exposure history. We present a case of a 45-year-old male initially diagnosed with Helicobacter pylori whose symptoms persisted and was ultimately diagnosed with Strongyloides infection.