Introduction Eosinophilic gastroenteritis (EGE) is a rare idiopathic disease that can affect one or more organs of the digestive tract. It has an estimated incidence of 1–20 cases per 100,000 patients. Klein et al. classified EGE into 3 subtypes: predominant mucosal, muscular, or subserosal. Clinical Case We report a case of a 32-year-old woman, who presented with diffuse abdominal pain, nausea, postprandial infarction, diarrhea, and moderate ascites of three-week evolution. The rest of physical examination did not show alterations. The past medical history was unremarkable. Laboratory test results revealed peripheral blood eosinophilia. Abdominal CT scan revealed diffuse and concentric parietal thickening of the distal 2/3 of esophagus, moderate volume ascites, and small bowel wall thickening and distension on the left quadrants. The paracentesis revealed 93.3% of eosinophils. The colon biopsies evidenced an increase in the number of eosinophils. Secondary causes of eosinophilia were excluded. The patient was treated with oral prednisolone 40 mg/day with immediate clinical and analytical improvement. Conclusion Eosinophilic gastroenteritis is a rare condition with a nonspecific and highly variable clinical presentation, which requires a high level of clinical suspicion. It is a diagnosis of exclusion. Secondary causes of eosinophilia such as intestinal tuberculosis, parasitosis, and malignant neoplasms should be excluded.

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antecedents, he had typhoid fever at 7 years old, malaria at 27 years old, sequelae of upper limb trauma, non-insulin dependent type 2 diabetes mellitus, hypertension, dyslipidemia and benign prostatic hyperplasia. Usually medicated with metformin, losartan/ hydrochlorothiazide, simvastatin, omeprazole and finasteride. He reported regular contact with chickens and past contact with pigeons and bats in the 10 years that he lived in Guinea-Bissau. He complained of fatigue and dyspnea (modified Medical Research Council grade 4) with about 2 years of evolution and had performed several exams but not conclusive. He was eupneic at rest with O2 saturation of 90%, afebrile, emaciated aspect, without palpable adenopathies. Pulmonary auscultation with disperse crepitations in both lung fields and rhythmic cardiac auscultation, with degree III / VI holosystolic murmur. Analytically, it had mild leukocytosis (11.910/μl) with neutrophilia of 84.4%, hemoglobin of 12.5g/dl, glucose of 132mg/dl, sedimentation rate of 94mm/h, C-reactive protein of 5.30mg/dl, autoimmunity with anti-mitochondrial antibodies on the order of 160 (N <80) with the remaining study negative. Serologies for HIV 1 and 2 were negative. The chest radiograph showed a bilateral reticular pattern and pseudo-nodular infiltrates at the upper third of both lung fields and the lower right third. The pulmonary function tests revealed mixed ventilatory syndrome with FEV1 of 62% and TLC of 75% (Table 1). The arterial blood gas analyses revealed partial respiratory failure with PaO2 of 54.1mmHg. Computed tomography of the chest showed bilateral traction bronchiectasis at the level of the lower lobes. Thickening of the bronchial walls and densification of the bronchovascular sheaths bilaterally associated with multiple foci of densification with bilateral peribroncovascular distribution. There was mediastinal ganglia at the aorto-pulmonary window with a maximum diameter of 12 mm. Common pulmonary artery trunk with 34mm and presence of cardiomegaly (Figure 1).

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