Indiana University Infectious Diseases Fellowship
23 Aug 20,
12 tweets, 3 min read
#idboardreview 30 M Saudi with fever, dyspnea, cough, patchy infiltrates, eosinophilia. Diagnosis? #medEd #IDMedEd 
#ascariasis loeffler syndrome cdc.gov/parasites/asca…
Early symptoms of ascariasis, during initial lung migration (10-14d after ingestion):cough, dyspnea, wheezing, urticaria, hemoptysis & chest pain. may be seasonal after rains in some countries, such as Saudi Arabia. Returning travelers could also present with Loeffler syndrome
Ascaris species are very large (adult females: 20 to 35 cm; adult males: 15 to 30 cm) nematodes (roundworms) that parasitize the human intestine. A. lumbricoides is the primary species involved in human infections globally,
heavy infections in children: stunted growth via malnutrition but adult worms usually cause no acute sx. High worm burdens may cause abd pain & intestinal obstruction & potentially perf. Migrating adult worms may cause occlusion of biliary t, appendicitis, or np expulsion
Tx: albendazole or mebendazole or pyrental pamoate 1-3d
Loeffler's syndrome occurs 10-12d after ingestion of Ascaris eggs (or 5–10d after penetration of hookworm or Strongyloides larva) & if there are any symptoms, is characterized by development of 5-10d of nonproductive cough, burning chest pain & frequently wheezing/rales.
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