Ascariasis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
The physical examination findings in ascariasis vary and it is usually dependent on the worm burden and the involved organ.<ref name="Nelson Textbook of Pediatrics">Kliegman, Robert; Stanton, Bonita; St. Geme, Joseph; Schor, Nina (2016). "Chapter 291:Ascariasis (Ascaris lumbricoides)". Nelson Textbook of Pediatrics Twentieth Edition. Elsevier. pp. 1733–1734. ISBN 978-1-4557-7566-8.</ref> | |||
==Physical Examination== | ==Physical Examination== | ||
===General appearance=== | ===General appearance=== | ||
Most patients generally appear well with minimal or no symptoms on physical examination. | Most patients generally appear well with minimal or no symptoms on physical examination.<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref> | ||
===Vital signs=== | ===Vital signs=== | ||
A low-grade fever may occur in some patients with ascariasis | A low-grade [[fever]] may occur in some patients with ascariasis.<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref> A high grade [[fever]] may be seen when there are complications such as acute [[cholangitis]], [[hepatic abscess]], etc.<ref name="pmid24926166">{{cite journal| author=Das AK| title=Hepatic and biliary ascariasis. | journal=J Glob Infect Dis | year= 2014 | volume= 6 | issue= 2 | pages= 65-72 | pmid=24926166 | doi=10.4103/0974-777X.132042 | pmc=4049042 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24926166 }} </ref> | ||
===HEENT=== | |||
An icteric sclera due to [[Jaundice|obstructive jaundice]] from biliary ascariasis may be seen.<ref name="pmid23239771">{{cite journal| author=Keating A, Quigley JA, Genterola AF| title=Obstructive jaundice induced by biliary ascariasis. | journal=BMJ Case Rep | year= 2012 | volume= 2012 | issue= | pages= | pmid=23239771 | doi=10.1136/bcr-2012-007250 | pmc=4544173 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23239771 }} </ref> | |||
===Chest=== | ===Chest=== | ||
[[Eosinophilic pneumonia]] ([[löffler's syndrome]]) may occur in severe cases with the patient presenting with the following physical examination findings:<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref><ref name="Murray and Nadel's Textbook of Respiratory Medicine">Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). "Chapter 39:Parasitic Infections". Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.</ref> | |||
* [[Dyspnea]] | |||
* Dry [[rales]] | |||
* [[Wheezing]] resulting from [[bronchospasms]] | |||
===Abdomen<ref name="Nelson Textbook of Pediatrics">Kliegman, Robert; Stanton, Bonita; St. Geme, Joseph; Schor, Nina (2016). "Chapter 291:Ascariasis (Ascaris lumbricoides)". Nelson Textbook of Pediatrics Twentieth Edition. Elsevier. pp. 1733–1734. ISBN 978-1-4557-7566-8.</ref>=== | |||
* Abdominal tenderness- Abdominal tenderness can be secondary to [[intestinal obstruction]], [[appendicitis]], [[biliary colic]], acute [[cholangitis]], [[acute cholecystitis]], [[hepatic abscess]], etc.<ref name="pmid24926166">{{cite journal| author=Das AK| title=Hepatic and biliary ascariasis. | journal=J Glob Infect Dis | year= 2014 | volume= 6 | issue= 2 | pages= 65-72 | pmid=24926166 | doi=10.4103/0974-777X.132042 | pmc=4049042 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24926166 }} </ref> | |||
* [[Abdominal distension]] | |||
* Signs of acute [[bowel obstruction]] | |||
===Skin=== | ===Skin=== | ||
The patients with ascariasis can present with [[urticaria]].<ref name="Nelson Textbook of Pediatrics">Kliegman, Robert; Stanton, Bonita; St. Geme, Joseph; Schor, Nina (2016). "Chapter 291:Ascariasis (Ascaris lumbricoides)". Nelson Textbook of Pediatrics Twentieth Edition. Elsevier. pp. 1733–1734. ISBN 978-1-4557-7566-8.</ref> | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
The physical examination findings in ascariasis vary and it is usually dependent on the worm burden and the involved organ.[1]
Physical Examination
General appearance
Most patients generally appear well with minimal or no symptoms on physical examination.[2]
Vital signs
A low-grade fever may occur in some patients with ascariasis.[2] A high grade fever may be seen when there are complications such as acute cholangitis, hepatic abscess, etc.[3]
HEENT
An icteric sclera due to obstructive jaundice from biliary ascariasis may be seen.[4]
Chest
Eosinophilic pneumonia (löffler's syndrome) may occur in severe cases with the patient presenting with the following physical examination findings:[2][5]
- Dyspnea
- Dry rales
- Wheezing resulting from bronchospasms
Abdomen[1]
- Abdominal tenderness- Abdominal tenderness can be secondary to intestinal obstruction, appendicitis, biliary colic, acute cholangitis, acute cholecystitis, hepatic abscess, etc.[3]
- Abdominal distension
- Signs of acute bowel obstruction
Skin
The patients with ascariasis can present with urticaria.[1]
References
- ↑ 1.0 1.1 1.2 Kliegman, Robert; Stanton, Bonita; St. Geme, Joseph; Schor, Nina (2016). "Chapter 291:Ascariasis (Ascaris lumbricoides)". Nelson Textbook of Pediatrics Twentieth Edition. Elsevier. pp. 1733–1734. ISBN 978-1-4557-7566-8.
- ↑ 2.0 2.1 2.2 Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
- ↑ 3.0 3.1 Das AK (2014). "Hepatic and biliary ascariasis". J Glob Infect Dis. 6 (2): 65–72. doi:10.4103/0974-777X.132042. PMC 4049042. PMID 24926166.
- ↑ Keating A, Quigley JA, Genterola AF (2012). "Obstructive jaundice induced by biliary ascariasis". BMJ Case Rep. 2012. doi:10.1136/bcr-2012-007250. PMC 4544173. PMID 23239771.
- ↑ Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). "Chapter 39:Parasitic Infections". Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.