Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Bone pain is an important symptom that can be severe. Eosinophilia without any other abnormal laboratory findings is rare in ALL. Strongyloides stercoralis in ALL causes disseminated fatal disease.Case Presentation: This 9-year-old girl presented with bone pain in lumbar region. Bone pain was the only symptom. The patient didn' t have organomegaly. The BM samples were studied by flow cytometry, which showed pre-B cell ALL. Larva of Strongyloides stercoralis was found in fecal examination. Plain chest x ray showed bilateral para-cardiac infiltration.Strongyloidiasis was treated before starting chemotherapy. After two days treatment with Mebendazol the patient developed cough, dyspnea, respiratory distress and fever. The treatment changed to Ivermectin for 2 days.Chemotherapy started five days after diagnosis of leukemia.Conclusion: The patient complained merely of bone pain in lumbar region without any other signs and symptoms. Peripheral blood smear showed eosinophilia without any other abnormality. Stool examination showed Strongyloides stercoralis larvae. We suggest that all patients diagnosed as ALL in tropical and subtropical regions should be evaluated for parasitic infection especially with Strongyloides stercoralis.

Acute appendicitis is one of the most common causes of abdominal emergent surgical disease worldwide. Enterobius vermicularis, a human intestinal parasite, is reported to be associated with acute appendicitis. We report a case of an 8-year-old girl who was admitted to the emergency unit with complaints of severe abdominal pain and was diagnosed with acute appendicitis. Microscopic pathological examination showed lymphoid follicles with prominent germinal centers and mantle zones within the appendix wall. Cross-sections of multiple female and male Enterobius vermicularis worms and a few longitudinal sections of E. vermicularis were seen. E. vermicularis is one of the most common human parasitic infections, so the possibility of infection of the appendix with E. vermicularis should be considered in the differential diagnosis of agents of appendicitis.

Background and Objective: Strongyloides infection is usually asymptomatic in healthy individuals; however, immunocompromised patients are subject to potential hyperinfection involvement. Hereby, we report disseminated and hyperinfection strongyloidiasis in two immunosuppressed patients from north of Iran, an endemic region for Strongyloides stercoralis. Case description: After assessment of clinical symptoms, disseminated strongyloidiasis was identified in the first case with pemphigus vulgaris by the presence of abundant larvae in direct stool smears and gastric biopsy. The second patient had metastatic carcinoma and was hospitalized with complicated symptoms. The infection was diagnosed by detection of numerous first-stage larvae in wet mount stool smears and agar plate analysis. Despite antiparasitic treatment, both patients died during the hospitalization. Conclusion: Delayed diagnosis of active strongyloidiasis in immunosuppressed patients can lead to hyperinfection syndrome. Thus, screening for S. stercoralis infection in these patients is recommended in endemic regions to reduce mortalities.

BACKGROUND: Strongyloides stercoralis (S. stercoralis) is endemic in the northern provinces of Iran, and to identify it, in addition to clinical tests, clinical manifestations of the patient are also needed. This study aimed to investigate the clinical manifestations of patients with S. stercoralis infection. CASE REPORT: Nine patients with S. stercoralis infection were investigated in this study. Out of 9 patients studied, 6 patients lived in the village. Clinical symptoms of patients included cough, cough with sputum, bloody sputum, fever, chills, respiratory disorder, diarrhea and melena, abdominal bloating, weakness, weight loss, blurred vision, double vision, headache, dizziness, severe burning behind the sternum, digestive disorders, heartburn, nausea, vomiting, lethargy, loss of appetite, purulent discharge from the ear, ear disorders, and imbalance. Fever, chills, and cough were common symptoms in almost all patients. CONCLUSION: Clinical symptoms in patients were different and similar in cases where cough, fever, chills, and respiratory and digestive disorders were reported in almost all of them. Rapid identification and treatment of S. stercoralis is essential, especially in patients with immune system deficiency.

Strongyloides stercoralis is a common cause of gastrointestinal infection. Symptoms are usually mild, but in the setting of impaired host immunity, severe and disseminated illnesses may occur. The present report describes a male patient with a history of asthma and corticosteroid therapy, now presented with dyspnea and abdominal pain. Examinations show Strongyloides stercoralis larvae in Bronchoalveolar lavage fluid specimens. The patients who have undergone immunosuppressive therapy are highly indicated for Strongyloides stercoralis screening which prevents hyperinflation in endemic areas.

Cestodes are important parasites that can affect the health of humans and wildlife. Among these, the genus Passerilepis is an important endoparasite of Passeriform birds while poorly studied in Iran. During a parasitological field survey in central parts of Iran in 2018, thirty-two cestodes, as an obstructive intertwined mass, recovered from the intestine of a recently dead Parus major (great tit). Morphological characteristics of recovered cestodes were drawn carefully by a camera lucida equipped microscope and identification was carried out using standard keys. All of the collected cestodes were identified as P. parina. In the current study, we recorded P. parina from great tit for the first time in Iran.