Case report: The diagnostic dilemma created by non-infectious diffuse abdominal pain and hypereosinophilia in a teenage boy

When abdominal pain presents with peripheral eosinophilia, allergic and infectious causes should be considered. However, diagnostic dilemmas are frequent when symptoms do not match expected patterns of common etiologies. In this report, we present the case of a 13-year-old male who presented with diffuse abdominal pain and peripheral eosinophilia. Though the initial assessment suggested an infectious cause, the infectious workup was negative. A broad workup, including imaging, laboratory studies, and endoscopy, was performed. Targeted endoscopic biopsies revealed extensive eosinophilic gastrointestinal disease as the underlying pathophysiologic cause. A broad differential and extensive workup is often crucial for accurate diagnosis of abdominal pain with hypereosinophilia.