Tuesday, February 28, 2017

Case of the Week 436

This week's case was generously donated by Dr. Sabarinathan from Madras Medical College in Chennai, India. The patient is a young man with a 2-week history of epigastric pain and vomiting. Physical examination was normal, and a complete blood count showed only a mild anemia (hemoglobin of 9.8 g/dL). An ultrasound of the abdomen was normal and so an upper gastrointestinal endoscopy was performed. This is what was seen:
Identification?

10 comments:

aubreynoelle said...

ascaris lumbricoides?

Anonymous said...

Ascaris

DM said...

They look like Ascaris.

Anonymous said...

A very impressive rendition of Ascaris lumbricoides live. This is consistent with a history of epigastric pain and mild anemia.
Florida Fan

سكوت هنصوت said...

Typical shape of an Ascaris

Anonymous said...

Could anyone explain why it isn't Anisakis? I thought that when there is nematode in stomach it must be Anisakis. But I'm green in it.

Anonymous said...

ascaris lumbricoides
Anisakis usually individual worms, but never say never in Microbiology. !

Zachary Telfer said...

I think the size of the worms is more indicative of the giant intestinal round worm (Ascaris). From the images I have seen of Anisakis, they are on the order of centimeters; whereas, these worms were on the order of tens of centimeters. The vague abdominal pain, anemia, and upper endoscopy video of large worms with very serpiginous moment, would suggest a diagnosis of ascariasis. Treatment with a "bendazole" should do the trick otherwise if they are causing obstruction remove them while you are in there.

William Sears said...

ascaris

Anonymous said...

Ascaris