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
- Fever
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]
The adult worms can be stimulated to migrate by stressful conditions (eg, fever, illness, or anesthesia) and by some antihelmintic drugs. [meddean.luc.edu]
The patient presented with eosinophilia, and abnormal liver function results, but no fever or hepatomegaly. [ncbi.nlm.nih.gov]
Complications Bronchopneumonia may be seen during the pulmonary migrational stage, producing fever, cough, dyspnea, wheeze, eosinophilia, and pulmonary infiltrates (Löeffler syndrome). [unboundmedicine.com]
- Anemia
Laboratory blood findings revealed sideropenic anemia and stools positive for Ascaris lumbricoides. Anti-parasitic therapy with mebendazole was repeatedly administered with early improvements but soon after symptoms relapsed. [ncbi.nlm.nih.gov]
Laboratory assessment was notable for anemia (hemoglobin level, 8 g per deciliter). Her clinical symptoms were suggestive of intestinal obstruction. She was brought to the operating room for an emergency laparotomy. [nejm.org]
Ascariasis predominates in areas of poor sanitation and is associated with malnutrition, iron-deficiency anemia, and impairments of growth and cognition. [web.archive.org]
Exclusion criteria were known HIV infection, allergy to albendazole, severe anemia, and any other underlying severe physical condition. [aac.asm.org]
- Infertility
A lumbricoides fertilized egg.jpg 616 × 436; 23 KB A. lumbricoides fertile egg.png 100 × 134; 10 KB A. lumbricoides infertile egg.png 97 × 192; 15 KB An American text-book of the diseases of children (1895) (14595729199).jpg 1 464 × 2 264; 289 KB Ascaris [commons.wikimedia.org]
When infections with only female worms occurs, infertile eggs that do not develop into the infectious stage are produced. With male-only worm infections, no eggs are formed. [stanford.edu]
- El Salvador
Association between intestinal parasitic infections and type of sanitation system in rural El Salvador. Trop Med Int Health. 2006; 11 :1821–1831. [ PubMed ] [ Google Scholar ] 62. Wördemann M, Polman K, Diaz RJ, Heredia LTM, Madurga AMC, et al. [ncbi.nlm.nih.gov]
Corrales LF, Izurieta R, Moe CL (2006) Association between intestinal parasitic infections and type of sanitation system in rural El Salvador. Trop Med Int Health 11: 1821–1831. View Article Google Scholar 62. [dx.doi.org]
- High Fever
High fever, diarrhea, spicy foods, anesthesia and other stresses have all been associated with an increased likelihood of worm migration [10]. [stanford.edu]
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]
- Constipation
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]
- 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]
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]
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]