Strongyloides stercoralis, a nematode parasite, is endemic in tropical and subtropical regions. Infection usually remains asymptomatic, but in immunocompromised hosts hyperinfection and dissemination can occur, which has a high mortality. Early detection of S. stercoralis may alter the fatal course of infection. We present our experience of five patients with S. stercoralis hyperinfection diagnosed by endoscopic duodenal and jejunal biopsy in northern India. A predisposing factor was present in all patients in the form of corticosteroid intake, chronic liver disease and panhypogammaglobulinaemia. Common gastrointestinal symptoms were abdominal pain, diarrhoea, gastrointestinal bleeding, nausea, vomiting and weight loss with evidence of malabsorption. The initial stool examination and peripheral blood eosinophil count were normal in all patients. Strongyloidiasis was not suspected clinically in any patient and the diagnosis was achieved on endoscopic biopsy. Three of the patients with disseminated disease developed fatal Gram-negative systemic infection. This study highlights the importance of considering strongyloidiasis in all patients on immunosuppressive drug therapy who present with gastrointestinal symptoms so that the patient can be appropriately investigated and promptly treated. In endemic regions, patients with systemic Gram-negative bacterial infections without an obvious cause should be tested for strongyloidiasis.

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Introduction: Sinonasal masses are a wide range of pathologies ranging from simple nasal polyps to rare tumors like esthesioneuroblastomas. Early symptoms of all of them are similar to common nasal and sinus problems, hence, producing a delay in diagnosis. . Detailed history and ENT examination were recorded. Radiological investigation was carried out in the form of computed tomographic (CT) scan of nose and paranasal sinuses. Final diagnosis was made by histopathological examination either before instituting any form of treatment or by a postsurgical biopsy where surgery was carried out. Immunohistochemistry was done in some cases as deemed necessary by the pathologist. Thus, their modes of presentation, radiological and histopathological profiles were studied along with dilemmas in diagnosis and management.Results: A total of 189 nasal masses were observed during this period. Out of which 126 were diagnosed as nasal polyps and were excluded from the study. Thus, 63 uncommon nasal masses were seen in the study period. A large number of uncommon sinonasal masses had atypical presentation and/or presented in an advanced stage to pose a diagnostic and surgical challenge. Endoscopic techniques are becoming a gold standard in surgical resection in most of them. Interdepartmental cooperation is highly essential.

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