infection . The constipation brought intestinal obstruction high on the differential but only secondary to parasitosis , since coughing is unusual . Labs measuring liver function and CT of abdomen were not warranted .
Treatment
Patient was prescribed one tablet of Pyrantel orally in clinic and one more tablet in two weeks . Education and reassurance were provided and the mother was encouraged to continue to observe the stool for further A . lumbricoides worms over the coming weeks . The patient ’ s mother was encouraged to return to the clinic if symptoms worsen .
Outcome and Follow-Up
Patient resolved without any complications .
Discussion
After completing a PubMed search for the parasite , many of the articles included infection leading to dangerous complications like gall-bladder perforation and biliary complications resulting from the migration of the worm during the life cycle . Of note , many of the cases involving infection occurred in countries where water sanitization and resources are sub-optimal . 5 Although uncommon in the U . S ., it would benefit clinicians , medical students , and their future patients to be familiar with this disease process to avoid a preventable death . Recognizing abnormal symptoms is key to establishing a diagnosis of Ascariasis .
Learning Points
• Pediatric intestinal Ascariasis can present as a viral infection in its earlier stages .
• Prompt treatment of Ascariasis can prevent life-threatening sequelae .
• Clinicians must always have a degree of suspicion of common parasitic infections despite being in a developed country .
• Counseling patients on sanitation and close observation of children playing outside is imperative to decreasing risk of children contracting Ascariasis .
References
1 . Crompton DW . Ascaris and ascariasis . Adv Parasitol . 48:285-375 ; 2001 .
2 . M Balasubramaniam , P Sudhakar , M Subhashini , S Srinivasan , M Padma , V Chopra . Ascaris lumbricoides in the lacrimal passage . Indian Journal of Ophthalmology 48 : 53-54 ; 2000 .
3 . CJ Das , J Kumar , J Debnath , A Chaudhry . Imaging of ascariasis . Australasian Radiology 51 : 500-506 ; December 2007 .
4 . Gabriel Alejandro Molina , Antonio Rolando Torres , Paul Sebastián Llerena , Alberto Yu , Andrea Carolina Sánchez , María Mercedes Cobo . Ascaris lumbricoides and its almost deadly complication . Journal of Surgical Case Reports 2018 ; October 2018 .
5 . Esrey SA , Potash JB , Roberts L , Shiff C . Effects of improved water supply and sanitation on ascariasis , diarrhoea , dracunculiasis , hookworm infection , schistosomiasis , and trachoma . Bull World Health Organ 69 : 609-621 ; 1991 .
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Volume 118 • Number 5 nOVEMBER 2021 • 115