Abstract
INTRODUCTION: At present, strongyloidiasis is considered by the World Health Organizaiton (WHO) as one of the most neglected diseases. CASE REPORT: A husband and a wife, both born in the Moscow region and never having traveled, initially presented with fever and unexplained peripheral eosinophilia. Parasitological examination revealed Strongyloides stercoralis in feces samples. Helminth infection was strongly associated with poor sanitary conditions. While albendazole was ineffective, after the treatment with ivermectin, both patients were asymptomatic, their ELISA tests were negative, and no larvae of S. stercoralis were found in the feces. CONCLUSIONS: We concluded that patients with unexplained eosinophilia must be checked for the presence of parasites before steroid or immunosuppressive therapy. These patients, if infected, may develop the highly fatal hyperinfective syndrome. The cases reported here raise concern about possible hidden strongyloidiasis in the Moscow region and re-emergence of this infection in this and other temperate regions in Russia.