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HELMINTH GENUS NAMES TO MATCH TO THE CASESTUDY:      

Taenia Ascaris Enterobius

Schistosoma Trichinella

Case 1:

A 4-year-old female arrived at the emergency departmentwith abdominal pain, vomiting and a 3-day history of diarrhea. Shealso exhibited tachycardia, bloating with no bowel sounds, and apalpable mass in the area of the right ileum. An X-ray of the arearevealed air fluid levels and the shadow of roundworms in a“whirlpool” image. The ileum was nearly obstructed, and the patientunderwent laparotomy to remove the worms. A mass of white worms wasremoved, with the smallest measuring 16 cm in length and thelargest 35 cm in length.

After surgery, the patient was given hydration andantibiotics for 72 hours. Once peristalsis restarted, the patientwas placed on albendazole for 3 days and was told to return foranother round of albendazole in 6 weeks.

Genus Name of Causative Agent___________________________________

Mode of Transmission to the adult________________________________________________________

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Case 2:

A 30-year-old man had made three trips to India betweenAugust 2012 and May 2013. On each trip, he had stayed for severalweeks with an assigned host family. After returning from the thirdtrip, the man noticed a subcutaneous nodule on his left neck. Thenodule was painless. It was also at this time the he reportedhaving a little nausea several hours after eating. When he noticed“noodle-like” material expelled in his feces, he sought medicalattention. A subsequent collection of a stool sample revealed smallwhite segments of gravid proglottids. A physical examinationrevealed other subcutaneous lesions that were palpable in the lowerjaw, neck and lateral abdomen. A biopsy of one of the lesions fromhis abdomen revealed a white cyst that showed characteristics of ascolex and an invaginated neck. The patient was diagnosed withdisseminated cysticercosis. He was treated with albendazole andoral prednisone for two weeks in an attempt to expel the worm orworms.

Genus Name of Causative Agent___________________________________

Mode of Transmission to the adult________________________________________________________

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Case 3:

A 39-year-old middle school biology teacher collectedshells as souvenirs for her students from her summer vacation inThailand and The Phillipines. She collected a large number ofshells from beaches, lakes, rivers and streams in both countries.After returning from her trip, she went to a health clinic withcomplaints of mild to moderate episodes of intestinal cramping. Thecramping had become more severe and frequent within the last twoweeks, and her abdomen felt bloated. She went to the clinic afternoting a small amount of blood in herstool.  

An examination revealed that the patient was slightlyfebrile and exhibited an elevated eosinophil count. A stool samplewas collected and sent for analysis. The examination revealed eggsthat measure 60 x 90 micrometers. No adult worms were found in thestool sample, but generally the adult worm is a fluke with separatemale and female forms. The worms are generally yellow to brown incolor and can measure 8-28 millimeters in length.

The patient was placed on praziquantel for 2days.     

Genus Name of Causative Agent___________________________________

Mode of Transmission to the adult________________________________________________________

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Case 4:

In December of 2016, a celebration gathering of friendsand family members dined on a variety of pork dishes. The pork meathad come from a domesticated wild boar raised and slaughtered on aprivate farm in Northern California. One of the pork dishes was inthe form of a traditional Laotian dish in which the meat is servedraw.

In January of 2017, one of the dinner attendeespresented to a hospital with fever, myalgia, abdominal pain,vomiting and diarrhea. The patient reported that four other friendsand family members had been evaluated at area hospitals with thesame symptoms. Bloodwork revealed 10% eosinophils. A subsequent IgGantibody test detected antibody against the suspectedpathogen.

Contact information was obtained for most of the peoplethat had attended the celebration. Overall, 36 of the attendeesexhibited symptoms of fever, muscle aches, bloating, vomiting anddiarrhea. Nine people were hospitalized: six with indication ofdamage to the myocardium, two with acute kidney injury and one withblood sepsis.

Samples of the raw pork were taken from leftover meatthat had been frozen and were analyzed microscopically. Cystscontaining spiraled juvenile worms were found in the frozen boarmeat. The farmer who raised the boar was asked if the farm hadinfestations of rats or mice.

The patients were placed on albendazole. Thosehospitalized required prolonged treatments.

Genus Name of Causative Agent___________________________________

Mode of Transmission to the adult________________________________________________________

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Case 5:

A 12-year-old male was seen at a gastroenterology clinicfollowing 2 weeks of abdominal pain. The patient also reported anitching sensation around the perianal region. The abdominal painwas diffuse (not localized) but had worsened in the prior 5 days.The pain was pronounced enough to prevent the patient fromattending school. He was evaluated for appendicitis, which wasruled out. A follow-up endoscopy was performed.

During the endoscopy procedure, small, mobile worms werenoted in the ascending colon. Two worms were collected: a male of2.5 mm in length and a female of 10 mm in length. Both worms had acuticle at the anterior end and a pointed tail. Eggs were alsoobtained, measuring 50-60 micrometers in size.

Usually, abdominal pain does not accompany this type ofinfection. In this case, the pain was attributed to an over-use ofNSAIDS. Since this worm generally does not enter the stool stream,examination of the stool is unreliable for detecting the worm oreggs. An application of transparent tape to the perianal region 2-3hours after the patient has gone to sleep is recommended to submitfor a microscopic examination.

The patient and his family were given a dose ofalbendazole with a repeat dose to follow in 2 weeks.

Genus Name of Causative Agent___________________________________

Mode of Transmission to the adult________________________________________________________