Ascaris lumbricoldes in the gallblader

Wednesday, 12 May 2010 15:22:17 GMT

A 34-year-old woman was admitted to the hospital with increased temperature, general weakness and exhaustion, chills from fever, lossof appetite, vomiting, pain in the abdomen, a salty bitter taste in her mouth, and dysuria. The discomfort started suddenly, 2 days before hospitalization, and did not stop after taking painkillers (metamizol).

Until this episode, the patient had been healthy, with no similar problems in her family. Her drinking water source is a well, which is treated with the addition of chlorine from time to time.

On admission, she was febrile (38.6°C), with normal blood pressure and moderate tachycardia (120 beats per min). The color of the patient’s skin was pale yellow, and the mucoses of the mouth and conjunctives were pale. The sclera of each eye was yellow, and the conjunctiva of each was pale. In addition, she had dental caries, pain in her abdomen below the right rib, and swollen ankles. The physical examination of other systems was normal.

The patient was anemic when she was admitted to the hospital (hemoglobin: 3.6 mmol/L; erythrocytes: 2.01 × 10¹²/L; reticulocytes:40%; leukocytes: 5.1 × 10⁸/L). Eosinophyls were 0.06% (0.02 to 0.04); the level of the proteins was low (total: 58 mmol/L; albumin:36 mmol/L; globulin: 22 mmol/L). The bilirubin values were normal (total bil-irubins: 6.5 µmol/L). Enzymes of the liver were in thenormal range: aspartate transaminase 151 µkat/L (normal to 567 µkat/L), ALT: 428 µkat/L (normal to 750 µkat/L). The level of the ﬁbrinogen was high: 15.88 g/L (normal to 11.0 g/L). Eggs of Ascaris lumbricoides were found in the patient’s stool. Chest radiography and abdominal ultrasonography was ordered.

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Ascaris lumbricoldes in the gallblader