Ascaris lumbricoides Beyond Intestinal Obstruction
Henrique Pott-Junior *
Division of Infectious Diseases, Federal University of São Paulo–UNIFESP, São Paulo, Brazil.
Alberto Pereira Ferraz
Division of Internal Medicine, Federal University of São Paulo–UNIFESP, São Paulo, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Ascaris lumbricoides infestation remains the most common cause of eosinophilia. In addition, in cases of severe eosinophilia due to helminthinfestation, eosinophilic infiltration of several tissues may occur, and most likely to be clinically underestimated. If not early diagnosed, it can be severe and fatal. We describe the case of a 33 year-old man from Brazil, a unique case of Ascaris lumbricoides hipereosinophilia with systemic involvement including the heart, kidneys, and bone marrow, without symptoms. Transthoracic echocardiography revealed a dilated left ventricle with an endocardial thickening. A percutaneous renal biopsy revealed diffuse global glomerulonephritis and tubulointerstitial nephritis with renal eosinophilic infiltration. Bone marrow biopsy revealed eosinophilic infiltration without any signs of malignant disorder. The patient was successfully treated and resulted in significant organ improvement. Early institution of empiric therapy may be the most effective approach while perform an extensive empirical evaluation for alternative causes of disease.
Keywords: Eosinophilia, Ascaris lumbricoides, glomerulonephritis, cardiomyopathies