In the United States, approximately 4 million people per year are infected
with Ascaris lumbricoides. We reviewed the common presentations of complica
tions of Ascariasis infection in the Emergency Department (ED) and the diag
nostic tools and treatment available, This was a retrospective case review
conducted on all patients diagnosed with Ascariasis (using ICD-9 codes) ove
r a 6-year period at Los Angeles County and University of Southern Californ
ia Medical Center. Three patients with distinct complications secondary to
Ascariasis were chosen, and all ED and inpatient records were reviewed. The
patient's age, sex, race, presenting symptoms, data, outcome, and ED cours
e and diagnosis were recorded. The three cases included a periappendiceal a
bscess, Loeffler's syndrome, and biliary colic/choledocholithiasis. The fir
st patient underwent a computed tomography-guided drainage of the abscess.
The second patient received supportive care and antibiotic therapy secondar
y to a superimposed bacterial pneumonia, The third patient underwent endosc
opic retrograde cholangiopancreatography with sphincterotomy. All three pat
ients had a stool ova and parasites positive for A. lumbricoides, and all r
eceived a 3-day course of mebendazole, Symptomatic cases of Ascariasis may
present to EDs in the United States. Important diagnostic tools for the ED
include chest X-ray, X-ray of the kidney-ureter-bladder and ultrasonography
. Single-dose medications given in the ED are very effective in eradicating
A. lumbricoides infection, thus avoiding hospitalization. (C) 2001 Elsevie
r Science Inc.