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A 74-year-old woman with a history since childhood of skin eruptionsand gastrointestinal problems was found to have peripheral eosinophilia.This finding was subsequently related to a chronic infectionwith the parasite Strongyloides stercoralis. This parasite iscapable of autoinfection, which would account for the infectionpersisting for about 65 years. The intraduodenal habitat ofS stercoralis and the negative results of numerous stool examinationsprompted the use of the duodenal string test, which was diagnostic.A high index of suspicion should exist for patients from endemicregions in Southeast Asia and the Southeastern United States.
