Bilateral parotid abscesses as the initial presentation of strongyloidiasis in the immunocompetent host

Abstract

Most suppurative parotid abscesses are unilateral and result from bacterial infection via Stensen's duct. Formation of bilateral parotid abscesses rarely occur, and cases arising in the setting of parasite infection have not been described to date. A 41-year-old man presented with bilateral parotid abscesses and underwent incision and drainage of right-sided swelling because of poor response to the aspiration drainage and intravenous antibiotic therapy. A nematode larva, morphologically consistent with Strongyloides stercoralis (S. stercoralis), was found in the cytologic examination, and bilateral abscesses regressed significantly after administration of Ivermectin. We report the first case of S. stercoralis infection presenting as bilateral parotid abscesses. This case expands the spectrum of diseases associated with S. stercoralis and suggests that clinicians, especially in the endemic regions, should consider S. stercoralis infection in the differential diagnosis of refractory parotid abscess.