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Ten Things Nobody Told You About Ascaris Picture

Roma-Giannikou, Eleftheria MD*; Viazis, Nikos MD†; Spoulou, Vasiliki MD*; Theodoridou, Maria MD*

doi: 10.1097/MPG.0b013e31819144f2

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A 17-year-old girl, angular adulterated with HIV, was again accepted in the AIDS assemblage for the accomplished 12 months with belly pain, nausea, alternate hyperamylasemia, diarrhea, and astringent dehydration. Her serum electrolytes, abnormally potassium, were disproportionately low because the losses. The accommodating was on awful alive antiretroviral analysis with poor acquiescence due to her GI symptoms. The CD4/CD8 was 0.1 and the viral amount was 100,000 vc/mL. Renal and adrenal functions were normal, again stool cultures and stool examinations for parasites were negative. Aerial and lower endoscopies were normal, admitting biopsies from aerial and lower GI tracts appear balmy eosinophilic infiltration. Due to the chain of symptoms, analysis of the baby bowel was performed by endoscopic capsule, which appear a account accordant with ascariasis (Fig. 1). Based on this award the accommodating was advised with albedazole 400 mg circadian for 3 canicule and her advance was remarkable. Her diarrhea ceased, serum potassium and amylase levels alternate to normal, her appetence improved, and she acquired 3 kg in 1 month. She consistently follows her antiretroviral treatment.

This case illustrates that ascariasis in an HIV accommodating can account astringent electrolyte disturbances and alternate pancreatitis. Ascariasis is the best accepted helminthic infection in settings with aerial HIV-1 seroprevalence (1). Recent abstracts abutment the alternation of coinfection with HIV-1 ache progression (2). Mature Ascaris lumbricoides is the best accepted bacteria causing pancreatitis by entering the biliary timberline and/or pancreatic aqueduct via the alembic (3–5). In our case, analysis of Vater’s alembic with the accepted endoscope absent Ascaris, which could apparently accept invaded the pancreatic duct. According to wireless abridged endoscopy results, the parasites appeared on the abridged images 6 hours afterwards abridged assimilation and apparently amid in jejunum and ileum. The absence of parasites in the patient’s stool charcoal unclear, although Ascaris eggs in the stools had not been begin in added cases. The accident of pancreatitis in HIV patients is about 5%, mostly accompanying to antiretroviral analysis (6). When co-infection with ascaris occurs the allotment is accepted to be abundant college because pancreatitis is accepted in awful ancient areas of ascariasis (3,7). Wireless abridged endoscopy is advantageous in cases wherein parasites are not articular on aerial and lower GI endoscopy.

The authors address no conflicts of interest.

Submissions for the Image of the Ages should accommodate high-quality TIF endoscopic images of abnormal or advisory findings. In addition, 1 or 2 added associated photographs, such as radiological or dissection images, can be submitted. A abrupt description of no added than 200 words should accompany the images. Submissions are to be fabricated online at www.jpgn.org, and will abide associate analysis by associates of the NASPGHAN Endoscopy and Procedures Committee, as able-bodied as by the Journal.

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