Taenia solium - 6'1" tapeworm removed PO

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nestey1
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Taenia solium - 6'1" tapeworm removed PO

Post by nestey1 » Sun Jan 29, 2017 7:40 am

http://www.nejm.org/doi/full/10.1056/NEJMicm1606747

(Austere Tx: starve, bowl of warm milk, forceps, eat 2 cigarettes but what is the best austere Dx?)

Image

A 48-year-old man presented with a 2-month history of abdominal discomfort and lethargy. Physical examination revealed pallor, and results from laboratory studies showed mild anemia (hemoglobin level, 9.2 g per deciliter [normal, 12 to 15 g per deciliter]). Colonoscopy revealed a proglottid from a tapeworm in the rectosigmoid colon, and gastroduodenoscopy identified its location in the proximal duodenum, extending distally (Video 1). A gastroscope and forceps were used to identify the tip of the tapeworm, and the tapeworm was extracted through the patient’s mouth (Panel A and Video 2). The tapeworm measured 188 cm in length (Panel B) and was identified as Taenia solium, also called the pork tapeworm. Endoscopic removal is not essential for management of T. solium infection; standard medical therapy is to administer either praziquantel or albendazole. In the case of this patient, after removal of the whole tapeworm, a dose of praziquantel was administered. One month after the extraction procedure, the patient remained asymptomatic.

https://www.rt.com/viral/375411-tapewor ... ved-mouth/

Liver specialist at the hospital, Dr. Cyriac Phillips, told LiveScience it was the longest worm he had ever seen, at 188 centimeters (6.1ft).

The medical team were performing a colonoscopy on the patient when they noticed a worm segment in his colon, confirming a tapeworm infestation.

They then carried out an endoscopy, a procedure which inserts a camera into the stomach and small intestine to view images of the digestive system, and got a glimpse of the lengthy worm sitting in the small intestine of the upper digestive tract.

The doctors examined the tip of the creature to confirm it was a tapeworm before extracting it through the patient’s mouth.

"Removal was more feasible through the mouth using an endoscope and blunt forceps, holding the head (or scolex) of the worm," Dr Phillips told RT.com.

The whole procedure took over an hour according to the medical team who later administered anti-parasitic medications to the patient to kill any tapeworm remnants.

The patient was examined one month after the parasite removal and was clear of any additional symptoms.

Tapeworms can grow to longer than 11 feet (3.5 meters) and can live for years in the human intestine, according to the US National Library of Medicine.

Infections, which usually don’t present symptoms in patients, develop from eating raw or undercooked meat of infected animals. The larva can then grow into an adult tapeworm while inside the human intestine. Typically, segments of the parasite are found in the gut, but it is unusual for a whole wriggling worm to be found inside a body.

-t

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