Routine stool microscopy unmasking strongyloidiasis: a case report from Eastern Uttar Pradesh

Strongyloidiasis is an intestinal parasitic disease caused by Strongyloides stercoralis, a soil-transmitted nematode. It is a common infection in Southeast Asia, including India, and is related to poor sanitation, rural residence, barefoot walking, and occupational exposure to soil. We report a case of a 71-year-old male farmer from rural Gorakhpur, Eastern Uttar Pradesh, who presented with intermittent watery diarrhoea for 2 years and tenesmus for 15 days. He was admitted with a diagnosis of fever of unknown origin. Routine stool microscopy revealed motile rhabditiform larvae of Strongyloides stercoralis, which were identified by their characteristic morphology, including a short buccal capsule and prominent genital primordium. Haematological examination revealed mild anaemia and eosinophilia. No other ova, cysts, or trophozoites were observed in the stool samples. The patient was treated with 200 µg/kg/day ivermectin for 2 days and showed clinical improvement. This case highlights the importance of routine stool microscopy in patients with chronic gastrointestinal complaints, especially in elderly patients from rural agricultural backgrounds.