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free120/Block 2/Question#19 (11.8 difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soilπŸ”

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submitted by madden875(12),

This worm is Ascaris. From an infectious disease doctor:

"The clue is the size- if you can see it move and it looks like an earth worm, it’s ascsaris! In dirt, kids get it from licking their dirty fingers! The adult looks like an earthworm and it causes the symptoms described with the worst cases causing bowel obstruction."

submitted by b1ackcoffee(34),

I am wondering which parasite is this actually? --

b1ackcoffee  @mdmofongo I know this. But which parasite is this? +  
drblu92  The parasite is most likely Trichuris trichiura (human whipworm). Trichuriasis is often asymptomatic and adult forms can reach 2 cm in length (visible with naked eye). A lot more common in tropical areas but there have been cases in the southeastern US (ex: Kentucky). All other GI worms would present with either a fever or a cough. Treat with mebendazole or albendazole. +6  
dhkahat  not trichuris....ascaris +  

submitted by dixie96(3),

trichuris trichiura can present with rectal prolapse in kids which perhaps accounts for why this boy thought he defacated in his pants

mes1717  will also see presence of worm on stoop O&P +  
madden875  this is ascaris, NOT trichuris +3  
j44n  i agree trichiura only get to 50mm +  

submitted by basic_pathology(8),

The gravid female pinworms (Enterobius vermicularis) migrate through the colon towards the rectum at a rate of 12 to 14 cm per hour.They emerge from the anus, and while moving on the skin near the anus, the female pinworms deposit eggs either through (1) contracting and expelling the eggs, (2) dying and then disintegrating, or (3) bodily rupture due to the host scratching the worm. After depositing the eggs, the female becomes opaque and dies.The female emerges from the anus to obtain the oxygen necessary for the maturation of the eggs.

lakshmi  Rectal exam showed no abnormalities. Wouldn't it more likely be a hookworm? +