Page 175 - Medical Parasitology_ A Textbook ( PDFDrive )

168 14 Case Reports

Source: Ngui, Romano, Sarala Ravindran, Diana Bee Lan Ong, Tak Kuan Chow,
Kah Pin Low, Zaidi Syeda Nureena, Yamuna Rajoo et al. “Enterobius vermicu-
laris salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient.”
Journal of Clinical Microbiology 52, no. 9 (2014): 3468–70.

Learning Points
1. Ectopic migration of Enterobius vermicularis can cause lesions with symptoms
in the female reproductive tract.

Case 12: Case Report on Anisakiasis
Case report: Patient is a 64-year-old man from Sarawak. He complained of abdom-
inal discomfort and passing of blood in his stool after eating sushi 2 days before.
On examination, the patient was afebrile, blood pressure of 124/88 mmHg, and
a pulse rate of 82 bpm. Abdominal examination was unremarkable with no tender-
ness or guarding upon palpation. Blood test showed haemoglobin of 10.1 g/dL, total
white cell count of 4.3 k/μL (neutrophils 47%, lymphocytes 40%, monocytes 9%,
eosinophils 3%, and basophils 1%), platelet count of 162,000/μL, and ESR of
7 mm/h. A colonoscopy was performed on the patient on the same day. A worm was
observed burrowing into the mucosa of the ascending colon. There was blood ooz-
ing from the penetration site with blood clots forming around the worm. The whole
worm was pulled out for identification. The specimen was examined under a stereo-
microscope, and it showed a nematode larva measuring approximately 25 mm long,
off-white in colour, and moving actively. Histological examination of the cross sec-
tions of the worm showed the characteristic Y-shaped lateral epidermal cords which
is diagnostic of Anisakis which was confirmed with PCR and sequencing.

Source: Amir, Amirah, Romano Ngui, Wan Hafiz Wan Ismail, Kum T. Wong,
Jaxinthe SK Ong, Yvonne AL Lim, Yee-Ling Lau, and Rohela Mahmud.
“Anisakiasis Causing Acute Dysentery in Malaysia.” The American Journal of
Tropical Medicine and Hygiene 95, no. 2 (2016): 410–2.

Learning Points
1. Detailed history including dietary history has to be taken from patients with
gastrointestinal symptoms. Thorough physical examination and investigation
cannot be overemphasized.

Case 13: Zoonotic Brugia pahangi Filariasis
Case report: Five patients (P1–P5) were referred to a medical centre between
October 2003 and September 2006. All patients except P4 lived near a hill in
Petaling Jaya, a residential suburbia located 10 km southwest of Kuala Lumpur, the
capital city of Malaysia. The hill and its surroundings are a popular place for recre-
ational activities. However, there is no history or record of Brugia malayi infection
in this suburbia. Although P4 did not reside in this residential area, he frequently