Three common presentations of ascariasis infection in an urban emergency department

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.