Eosinophilic Oophoritis: Association With Positive Strongyloides stercoralis Serology and Clinical Response to Ivermectin

Background: Localized eosinophilic infiltration causing ovarian dysfunction is an unusual clinical problem. Case: We report a 16-year-old girl with abdominal pain, ovarian cysts, and biopsy-proven eosinophilic oophoritis, which resulted in right oophorectomy. Subsequently, a large cyst developed in the left ovary, causing abdominal pain that was worse at the time of her menses, and biopsy again showed numerous eosinophilic microabscesses. Unexpectedly, a parasite serology test to Strongyloides stercoralis was positive, although stool tests for ova and parasites were negative and the total IgE and total eosinophil count were normal. After treatment with ivermectin, the patient's abdominal pain resolved, the serologic antibody titers to S stercoralis returned to normal, and subsequent ultrasonographic evaluations showed involution of the large cyst in the remaining ovary. Conclusion: Eosinophilic oophoritis is a new disorder of localized tissue eosinophilia.