TWiP 235: The case of the regurgitated wriggler

TWiP solves the case of a man in his 50s reporting months of abdominal discomfort, who takes mebendazole and some time afterwards vomits a worm into the sink.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

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• The giant intestinal worm, Ascaris lumbricoides (TWiP 21)
• Parasitic Diseases Lectures #24: Giant Intestinal Worm (YouTube)
• Letters read on TWiP 235
• Hero: Ernst A. H. Friedheim

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New Case:

I first learned about this case from a colleague at work who tells me that their friend has just gotten really sick. The friend is described as having had multiple illnesses over time but that he has never been as sick as he recently got. He reports that the illness began as a diffuse myalgia with fever, there was some sore throat, noted swelling in the neck, and overwhelming fatigue. He tells some of his friends that he is feeling really terrible and it turns out that some of his friends also feel poorly. It turns out that about a week prior to the onset of his symptoms he and a number of friends attended a large dinner where venison and boar was served.

This individual is then seen in our office. Some testing is done. He feels really terrible and despite being reassured that he should get better without treatment he is given therapy.

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