The following case was generously donated by Dr. Sandeep T from Bangalore, India.
The patient is a 27 yr old lady with complaints of puffy ankles and face and a loss of appetite. On examination, she was pale and had pedal edema extending up to her knees bilaterally. Laboratory investigations showed anemia with a normal WBC count. The preliminary diagnosis was renal insufficiency, but further questioning revealed intermittent diarrhea and one episode of vomiting a 'worm'.
Therefore, endoscopy was performed which revealed the following red brown parasites attached to the wall of intestine, extending from the duodenum to the colon.
Some of the smaller parasites were extracted and are shown below. They ranged in size from 2 to 3.5 cm in length by 1.5 cm in width.
Stool ova and parasite exam revealed the following eggs (no size available)