A Case Study of a Patient with Ascariasis

GROUP 3: Factora, Klaudette

Gabuten, Mariaella TeresitaGonzales, Abigael

Gonzales, Karen VivienneHaluag, Dennilee Rose

Ibasco, Angel Paulyn Mabel

Biographical DataName: N/AAge: 3 years oldAddress: Smoky Mountain of NavotasGender: Male

Case of the PatientHistory of Present Health Concern(Chief Complaint)

    Two days prior to consult, the patient presented, mild, colicky pain on the lower right quadrant of the patient’s abdomen accompanied by malaise and anorexia. 24 hours prior to consult, the symptoms presented by the client exacerbated. The patient feels feverish and vomited twice with large worm. The patient did not have any episodes of chills, nor diarrhea, dysuria and hematuria. Persistence of pain promted the patient to consult the doctor.

Lifestyle and Health Practices

Activities on a typical day: Playing with his brothers in the nearby mountain of soil and garbage

Relationships with family: 6th among 8 siblings, lives with his family

Residency: Smoky Mountain of Navotas Type of Environment: Polluted, Smoky, Foul-odor Environmental Risks: Near the dumping site of

garbage materials, near the mountain of soil and garbage

Introduction   One of the most common parasitic infection worldwide is the Ascariasis, it is usually experienced in tropical countries as well as in developing countries. It is caused by Ascaris lumbricoides a nematode, also known as the “Giant intestinal roundworm”.

It is a parasite, so it is an organism that feeds on the nourishment of its host. It cannot survive on its own. And it is under the group of Helminths, a multicellular and chemoheterotrophic group of organisms.

  According to the case report of Department of Pediatrics and Radiology, Shifa College of Medicine and Shifa International Hospital, Islamabad, approximately 25 percent of the world’s population or nearly 807 million cases have been noted for this disease. In addition, roughly 1.5 billion individuals are infected with Ascaris lumbricoides in Africa and Asia.

It is also regarded as the "DISEASE OF POVERTY" .

Life Cycle

 

Signs and Symptoms

Abdominal Symptoms

a. Abdominal discomfort b. Nausea c. Diarrhea d. Anorexia e. Impaired nutritional absorption of dietary proteins, lactose and Vitamin A. f. Steatorrhea

  Respiratory Symptoms

a. Shortness of Breath b. Coughing (sometimes with bloody sputum) c. Wheezing d. Pneumonitis e. Low-grade fever

Liver and Pancreas Symptoms a. Hepatic Abscesses b. Biliary Colic c. Acalculous Cholecystitis d. Ascending Cholangitis e. Obstructive Jaundice f. Obstruction of the bile duct with peritonitis

Pertinent Clinical Findings

Physical Examination

Normal Value

Temperature 38°C 36-38°C

Pulse Rate 80 bpm 90-150 bpm

Respiratory Rate 24 cpm 24-40 cpm

Weight 10 kgs 11-17.5 kgs

Laboratory ExaminationsNORMAL VALUES

Hematocrit 35% 34-39%

Hemoglobin 90 mg/dL 10.5-12.7 mg/dL

WBC 10.0 x 10^3/mm3 5.5-15.5 x 10^3/mm3

Neutrophils: 65% 34.3-72.9 %

Lymphocytes 22% 35-65%

Monocytes 3% 3-6%

Eosinophils 10% 0-3%

 

FindingsAccording to the History of Present Health concern of the patient, the abdominal pain is:

Character: Mild, colickyOnset: 2 days priorLocation: Right lower quadrantSeverity: Moderately severePattern: PersistentAssociated Factors: Fever, Chill, Vomiting

 

Treatment

Albendazole Prescribed amount: 15 mg/kg/day given in divided doses twice daily with meals (maximum total daily dose 800 mg).

Mebendazole Prescribed amount: dosage of 100 mg twice daily for 3 days.        

 

Treatment

Pyrantel PamoatePrescribed amount: single dose of 11 mg/kg body weightWeight of patient: 10 kgDose to give: 110 mg

Piperazine CitratePrescribed amount: dosage of 75 mg/kg body weight daily for 2 daysWeight of patient: 10 kgDose to give: 750 mg        

 

PreventionsNursing Interventions: Independent and Collaborative

1. Educate the parents of the patient to properly dispose human excrement like feces.2. Educate the patient’s relatives as well as the patient about the proper hand washing techniques.3. Instruct the patient and his relatives that playing in soil may cause Ascariasis as Ascaris eggs are usually found in soil and dirt.

  4. Teach the patient to avoid eating raw and unwashed foods and those that has been dropped on the floor. 5. Instruct the client not to put his fingers on his mouth especially when it is dirty.6. If infected, the individual should be treated with medicine to reduce disease transmission.

 

Diagnostic Procedures

Tests and procedures can be done to detect the presence of the worm such as the following:

* Stool Tests

* Blood tests

* Imaging tests a. X- rays b. Ultrasound c. CT scans or MRIs

 

REFERENCES:http://www.idspak.org/journal/2008/april-june/page72-74.pdfhttp://www.metapathogen.com/roundworm/http://www.who.int/water_sanitation_health/diseases/ascariasis/en/http://www.dpd.cdc.gov/dpdx/html/ascariasis.htmhttp://www.atlas.or.kr/atlas/alphabet_view.php?my_codeName=Ascaris%20lumbricoideshttp://www.mayoclinic.com/health/ascariasis/DS00688/DSECTION=causeshttp://www.wrongdiagnosis.com/a/ascariasis/symptoms.htm?ktrack=kcplink#symptom_listhttp://www.mayoclinic.com/health/ascariasis/DS00688/DSECTION=symptomshttp://www.livestrong.com/article/76287-ascaris-lumbricoides-symptoms/http://wiki.answers.com/Q/What_is_the_average_weight_of_a_3-year-old_boy http://www.babycenter.com/0_fever_11430.bc http://www.amperordirect.com/pc/r-personal-care-resource/z-normal-pedriatric-rate.html http://wps.prenhall.com/wps/media/objects/354/362846/London%20App.%20B.pdf http://wps.prenhall.com/wps/media/objects/3103/3178396/tools/normal_blood_values.pdf https://www.pediatriccareonline.org/pco/ub/view/Pediatric-Drug-Lookup/153930/all/Normal_Laboratory_Values_for_Children?amod=aapea&login=true&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+tokenhttp://en.wikipedia.org/wiki/Pyrantel_pamoatehttp://www.petplace.com/drug-library/pyrantel-pamoate-nemex-strongid-t/page1.aspxhttp://www.mayoclinic.com/health/drug-information/DR600879http://medical-dictionary.thefreedictionary.com/mebendazolehttp://en.wikipedia.org/wiki/Piperazinehttp://chemicalland21.com/lifescience/UH/PIPERAZINE%20CITRATE.htmhttp://www.healthline.com/goldcontent/albendazolehttp://en.wikipedia.org/wiki/Ascariasishttp://www.wrongdiagnosis.com/a/ascariasis/book-diseases-20a.htmhttp://www.mayoclinic.com/health/ascariasis/DS00688/DSECTION=preventionhttp://www.mayoclinic.com/health/ascariasis/DS00688/DSECTION=tests-and-diagnosis

  Thank you for listening! Good day! God bless!