The diverse manifestations of Strongyloides stercoralis in the upper gastrointestinal tract: Two cases and insights

Abstract Strongyloides stercoralis is an intestinal nematode that usually causes mild or asymptomatic chronic infection in immunocompetent individuals but can result in fatal hyperinfection or dissemination in immunocompromised hosts. Gastric involvement is rare and underreported. We present two histologically confirmed cases of S. stercoralis infection involving the upper gastrointestinal (GI) tract – one in an immunocompetent and the other in an immunocompromised patient. The first involved duodenal and gastric mucosa, and the second showed gastric strongyloidiasis in a patient on corticosteroids. Both highlight the diagnostic value of endoscopic biopsy and the differences in presentation between immune states. Strongyloides infection of the stomach and duodenum, though rare, should be considered in chronic GI symptoms even without overt immunosuppression. Early detection by endoscopic biopsy and timely treatment are vital to prevent fatal outcomes.