Farm to Harm: Parasite Infection in an Elderly Farmer on Long-term Steroids

We present a rare case of Enterobius vermicularis and Helicobacter pylori coinfection in an 82-year-old male from a rural area of Jodhpur, India. The patient had a long history of rheumatoid arthritis and chronic corticosteroid use, rendering him immunosuppressed. He presented with non-specific gastrointestinal symptoms such as abdominal pain, weight loss, malaise, and heartburn. Laboratory and stool analyses revealed the presence of a small worm, which was later identified as Enterobius vermicularis. Additionally, the patient tested positive for H. pylori infection through various diagnostic modalities. The patient responded well to a combination of Albendazole and an H. pylori eradication kit. This case highlights the unusual presentation of E. vermicularis in an elderly patient and its coinfection with H. pylori, typically not associated with this demographic.