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Airway obstruction by Ascaris, roundworm in a burned child
O Lapid1, Y Krieger, T Bernstein
1Department of Plastic and Reconstructive Surgery and Burn Unit, The Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheba, Israel. lapid@actcom.co.il
Insights
Ascaris lumbricoides, a common roundworm, caused severe airway obstruction in a burn patient. Removal of the 35cm worm dramatically improved her breathing, highlighting a rare complication of parasitic infection.
Area of Science:
- Medical Parasitology
- Critical Care Medicine
- Emergency Medicine
Background:
- Ascaris lumbricoides is a globally prevalent Nematode parasite.
- Severe burns necessitate intensive respiratory support, including mechanical ventilation.
- Airway complications can arise in critically ill patients.
Observation:
- A 10-year-old girl with extensive burns presented with hypoxemia requiring reintubation.
- Laryngoscopy revealed a foreign body obstructing the larynx, identified as a 35cm Ascaris roundworm.
- The patient experienced immediate respiratory improvement after worm removal.
Findings:
- Ascaris lumbricoides can cause life-threatening airway obstruction.
- Successful Magill forceps extraction of the roundworm resolved the respiratory distress.
- This case underscores the importance of considering parasitic infections in airway emergencies.
Implications:
- Highlights a rare but critical presentation of ascariasis.
- Emphasizes the need for thorough diagnostic evaluation in complex respiratory cases.
- Suggests awareness of helminthic infections as a potential cause of airway compromise.
Abstract:
Ascaris lumbricoides, roundworm, is a Nematode parasite infecting about 1 billion people worldwide. We report the case of a ten-year-old Bedouin girl hospitalized with burns to 45% of her body surface area, including the face. The patient was intubated upon admission and mechanically ventilated. Four days later she was extubated but required reintubation 15 min later for severe hypoxemia. Laryngoscopy disclosed an unidentified tube which obstructed the opening of the larynx. The 'tube' was removed by Magill forceps. The object was identified as a 35 cm long Ascaris roundworm. Once the worm was removed the patients' respiratory condition dramatically improved. We review the main features of Ascaris infection and some similar cases of airway obstruction caused by this worm.