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Ascaris lumbricoides Discharge from the Mouth
Yuya Kobayashi1, Jun Tsuyuzaki1
1Komoro Kosei General Hospital, Komoro, Japan.
Abstract:
A 68-year-old Japanese man presented with Ascaris lumbricoides discharge from his mouth. The infection was suspected to have occurred while the patient was in the Philippines. This A. lumbricoides migration occurred because a proton pump inhibitor was used and Billroth I resection had been performed, which reduced gastric acid secretion and increased gastric pH. In addition, the pylorus had been removed during Billroth I resection, enabling easy access to the stomach. The number of imported foods, of infected migrants and refugees, and of overseas travels is increasing, and these factors may lead to an increase in A. lumbricoides infection even in countries with a typically low incidence of such infections. Clinicians should bear in mind that parasitic infections may occur in nonendemic areas.
Insights
A 68-year-old man experienced Ascaris lumbricoides discharge due to reduced stomach acid after surgery and medication. This case highlights the increasing risk of parasitic infections in non-endemic areas.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Parasitology
Background:
- Billroth I resection and proton pump inhibitor use significantly reduce gastric acid secretion.
- Reduced gastric acidity and pylorus removal can increase the risk of parasitic infections, such as Ascariasis.
- Global travel and imported foods contribute to the spread of infectious diseases.
Observation:
- A 68-year-old Japanese man presented with Ascaris lumbricoides discharge from his mouth.
- The patient had a history of Billroth I resection and proton pump inhibitor use.
- The infection was suspected to have been acquired in the Philippines.
Findings:
- Post-surgical changes and medication led to increased gastric pH, facilitating Ascaris lumbricoides migration.
- The absence of the pylorus provided easy access for parasites to the stomach.
- This case demonstrates a potential increase in Ascaris lumbricoides infections in non-endemic regions.
Implications:
- Clinicians must consider parasitic infections like Ascariasis in patients presenting with unusual symptoms, even in non-endemic areas.
- Increased global travel and imported food necessitate heightened awareness of parasitic infections among healthcare providers.
- Understanding the impact of gastrointestinal surgery and medication on gastric acidity is crucial for diagnosing and managing parasitic infections.
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