Question

As a Peace Corps nurse in West Africa, you meet a 4-year-old girl with a particularly swollen stomach. She has been suffering four days of stomach pain, vomiting, and was severely constipated

The girl’s mother shows you a large (10-cm) white cylindrical worm that the girl coughed up. The worm is cylindrical with tapered ends.

1-Identification of the worm? Full name

2-Describe the parasite.

3-Information about how she contracted it?

4-Diagnosis & Treatment & Prevention

Answer 1

1. The worm she had is a roundworm parasite which is a large nematode. Its full name is Ascaris lumbricoids and the disease caused by this parasite is Ascariasis.

2. Basically, these roundworms are slightly pinkish white in color, large in size (which can range from 15-30 cms in length). They tend to infect gastrointestinal tract. Basically, they use body as a host system where these worms mature from eggs or larvae to adult worms. These adult worm undergo reproduction where they can be upto 30cms long. Here this worm infected the girl's gastrointestinal tract by entering in small intestine. Swollen stomach, vomitting and stomach pain is normally seen in childrens infected with this worms. This worm affects children mostly less than 5 yrs of age.

3. Their transmission route is faeco-oral. Here, the girl must have swallowed contaminated food or water and inturn ascaris eggs must have got swallowed. They entered in her small intestine wher they have matured into adult worms. From intestine they gain their entry in lungs via bloodstream.

4. a. Diagnosis - Here, the girl's mom showed the worm she coughed up. Alternatively, she may need more tests like ultrasound, stool sample test, MRI scan or even endoscopy. Basically, these imaging tests will help to tell how the worm has matured. How long she has been showing symptoms will be asked for in order to evaluate risk of some complications.

b. Treatment - Antiparasitic medications will be prescribed for her.

Albendazole (given as a single dose) and Mebendazole (given for 3 days for 2 times). The mg of this medication will be prescribed as per her body weight. These are the common antiparasites prescribed.

c. Prevention - Since, this infection is caused primarily via contaminated food and water, poor hygiene, education related to this hygiene and sanitation can prevent this infection to a large extent. Education related to enviornmental hygiene, personal hygiene and safe disposal of human waste is also equally important. Education regarding pig ascariasis must be given. Supervising children and telling them precautions that need to be taken when in close proximity towards pigs. Proper, healthy Nutrition must not be neglected.

Timely Washing hands with soap before handling or eating food, avoid touching face without cleaning hands can prevent this to great extent.

Washing fruits and vegetables properly to kill germ and parasitic eggs. This all can prevent this infection to a large extent.