Presentation
We present a case report of a 42-year-old Asian-Indian female presenting with a long-standing history of severe recurrent postprandial epigastric pain, requiring multiple hospital admissions. [ncbi.nlm.nih.gov]
Entire Body System
- Gangrene
Perforation and torsion with gangrene are its very rare fatal complications but an important cause of mortality in children. [ncbi.nlm.nih.gov]
Gangrene intestine caused by Ascaris lumbricoides; report of 5 cases in children. Pathol Res Pract 2010 ; 206 : 292 – 4. 5. Ascaris lumbricoides causing infarction of the mesenteric lymph nodes and intestinal gangrene in a child: a case report. [academic.oup.com]
The massive gastrointestinal bleeding with ulceration, perforation and even gangrene of the bowel wall are rare, fatal complications [16]. [emro.who.int]
- Disability
Mortality and Disability-Adjusted Life-Years (Dalys) for Common Neglected Tropical Diseases in Ethiopia,1990-2015: Evidence from the Global Burden of Disease Study 2015. Ethiop Med J. 2017;55(Suppl 1):3–14. [ncbi.nlm.nih.gov]
[…] it reduces the intensity of infection. 1 Introduction Ascaris lumbricoides (roundworm) infects 0.8 to 1.2 billion people worldwide and is a major cause of disease burden, especially in developing countries, with an estimated loss of from 1.2 to 10.5 disability-adjusted [oadoi.org]
An alternative approach proposed by the WHO ( WHO 2010 ) is to derive a health outcome target such as a tolerable burden of disease measured using disability-adjusted life years (DALYs). This approach is known as a health-based target ( WHO 2011 ). [iwaponline.com]
- Swelling
She had had a swelling of her right leg for twenty years and had recently been complaining of pain in the left lower portion of the chest. [jamanetwork.com]
Signs and symptoms of ascariasis may include the following: abdominal symptoms (discomfort, swelling, pain ), nausea, vomiting, fever, coughing, wheezing, passage of parasites and their eggs in stools. [medicinenet.com]
In one patient, acute interstitial nephritis was accompanied by pulmonary and hepatic involvement, and in one case by pulmonary infiltrates and generalized lymph node swelling. [academic.oup.com]
Gastrointestinal
- Abdominal Pain
A 28-year-old female presented to the emergency department with right upper quadrant abdominal pain, syncope, and seizure-like activity. [ncbi.nlm.nih.gov]
Upper endoscopy was performed in a 19-year-old man from Afghanistan because of four days of watery diarrhea and dysphagia without abdominal pain. Stool examination revealed no parasitic ova, and cultures were negative for bacterial pathogens. [nejm.org]
- Nausea
This essay presented a 78-year-old female case had severe abdominal pain, nausea and constipation for seven days and the pylorus was obstructed by A. lumbricoides and diagnosis was obtained by endoscopy. [ncbi.nlm.nih.gov]
Description: This 34 year old female resident of rural China presented with nausea and vomiting, vague abdominal pain and fever. An upper endoscopy was performed in Beijing. [web.archive.org]
When the worms are in the intestines, they may cause nausea, vomiting, irregular bowel movements, stomach pain, weight loss or malnutrition, or visible worms in vomit or stool. [study.com]
Abdominal distension and pain, nausea, and diarrhea are also typical symptoms (1). Among school children, the infection is associated with appetite loss, lactose maldigestion, impaired weight gain, and a reduction in cognitive abilities. [asmscience.org]
- Dyspepsia
Either way, ascariasis should be considered in the differential diagnosis of dyspepsia in individuals who emigrate from endemic areas. [ncbi.nlm.nih.gov]
- Failure to Thrive
Complications Chronic infestation with A. lumbricoides may be associated with a poor nutritional state, anaemia, failure to thrive and impaired cognition, particularly in children. [patient.info]
- Black Stools
He denied any recent symptoms of vomiting, constipation, diarrhea, blood in the stool, black stools, dysphagia, or weight loss. He reported that none of his family members had experienced similar symptoms. [ncbi.nlm.nih.gov]
Liver, Gall & Pancreas
- Jaundice
There was tenderness in the right hypochondrium and liver function tests confirmed cholestatic jaundice. [ncbi.nlm.nih.gov]
Worm migration can cause peritonitis, secondary to intestinal wall penetration Common bile duct obstruction resulting in acute obstructive jaundice. Diagnostic Tests: The diagnosis is established by finding characteristic eggs in the feces. [meddean.luc.edu]
Less frequent but more transcendental are other conditions such as acute cholecystic, cholangitis, liver abscess, obstructive jaundice, choledocolithiasis and acute and chronic pancreatitis (4,5). [scielo.isciii.es]
Pancreatitis, cholangitis, jaundice, liver abscesses. Respiratory tract obstruction. Prognosis [ 5 ] Uncomplicated infections respond well to treatment with anthelmintics. [patient.info]
Of these 300 patients, 98 percent presented with abdominal pain, 16 percent developed ascending cholangitis, 4 percent developed acute pancreatitis, and 1 percent developed obstructive jaundice. [stanford.edu]
Neurologic
- Vertigo
Vertigo (albendazole), throat pain (albendazole), fever (mebendazole), and a swollen face (mebendazole) were each reported once." [cochranelibrary.com]
Workup
Sections Ascaris Lumbricoides Overview Background Pathophysiology Epidemiology Prognosis Patient Education Show All Presentation History Physical Causes Complications Show All DDx Workup Laboratory Studies Imaging Studies Show All Treatment Emergency [emedicine.medscape.com]
X-Ray
- Pulmonary Infiltrate
A chest radiograph showed bilateral pleural effusion and bilateral pulmonary infiltrates in both lung fields. [archbronconeumol.org]
Complications Bronchopneumonia may be seen during the pulmonary migrational stage, producing fever, cough, dyspnea, wheeze, eosinophilia, and pulmonary infiltrates (Löeffler syndrome). [unboundmedicine.com]
Accompanying pathological symptoms include pulmonary infiltration, eosinophilia (symptoms of the overabundance of eosinophils in the blood such as asthma and allergic reactions), and a diagnostic symptom is, aside from standard microscopy of stools, radiographic [en.wikipedia.org]
In one patient, acute interstitial nephritis was accompanied by pulmonary and hepatic involvement, and in one case by pulmonary infiltrates and generalized lymph node swelling. [academic.oup.com]
Colonoscopy
- Polyps
Biopsy of all the polyps was also performed which turned out to be hyperplastic polyp for all the polyps. Anthelmintic treatment with Albendazole was started, and currently our patient lives a healthy and asymptomatic life with his spouse. [ncbi.nlm.nih.gov]
Treatment
The diagnosis requires an experienced radiologist and knowledge by the clinician of treatment options and of when a surgeon should be involved. [ncbi.nlm.nih.gov]
After treatment vast quantities of worms can be passed in the stool, and impressive photos of the results of treatment are noteworthy. [ascarislumbricoides.org]
A parasitological stool examination was performed before each treatment. [documentation.ird.fr]
Prognosis
Prognosis Once intestinal infection is detected and treated, the prognosis is excellent. If obstructive or respiratory complications have occurred, the prognosis is less favorable. [unboundmedicine.com]
What is the prognosis of ascariasis? The prognosis of ascariasis for appropriately diagnosed and treated ascariasis is very good. However, the prognosis begins to decline if the patient develops a high number of worms in the body (worm burden). [medicinenet.com]
After discharge and due to lack of follow up and self-care, she became infected again, this time making her prognosis more complex and her clinical presentation more difficult. [academic.oup.com]
Prognosis The prognosis for ascariasis is excellent. However, in higher worm burden infections, serious complications such as obstruction are more common. [emedicine.com]
Etiology
Pancreatitis is a common disease in the United States, with the most likely etiologies being biliary tract disease and alcohol use. [ncbi.nlm.nih.gov]
Infectious liver abscesses have a diverse etiology. [scielo.br]
Epidemiology
MeSH terms MeSH terms Adolescent Adult Aged Aged, 80 and over Animals Ascariasis/complications Ascariasis/epidemiology* Ascaris lumbricoides/immunology Ascaris lumbricoides/isolation & purification* Brazil/epidemiology Child Child, Preschool Diabetes [ncbi.nlm.nih.gov]
Open Access Article 1,2,3,†, Ya Yang 1,2,3,†, Yingjian Wang 1,2,3, Yu Yang 1,2,3, Shurong Dong 1,2,3, Yue Chen 4, Qingwu Jiang 1,2,3 and Yibiao Zhou 1,2,3,* 1 Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, [doi.org]
Pathophysiology
The biliary ascariasis pathophysiology is commented. [ncbi.nlm.nih.gov]
Pathophysiology: A lumbricoides is the largest of the intestinal nematodes affecting humans, measuring 15-35 cm in length. Infection begins with the ingestion of embryonated (infective) eggs in feces-contaminated soil. [web.archive.org]
Pathophysiology Fertilized eggs are ingested from soil contaminated with human feces. Larvae hatch in the small intestine and migrate to cecum and colon. [unboundmedicine.com]
Especially those who live in crowded and dirty, places with improper drainage of sewage [ 8 ], parasite causing them a slow development, affecting both physical and mental health [ 9, 10 ] by nutritional deficiencies induced [ 11, 12 ] by several pathophysiological [omicsonline.org]
Pathophysiology A lumbricoides is the largest of the intestinal nematodes affecting humans, measuring 15-35 cm in length in adulthood. Infection begins with the ingestion of embryonated (infective) eggs in feces-contaminated soil or foodstuffs. [emedicine.medscape.com]
Prevention
Detection, treatment and follow-up of these patients, and the organization of preventive measures remain challenging. [ncbi.nlm.nih.gov]