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Ascariasis and hyperosmolar hyperglycemic state: a surprising ultrasound finding in the emergency department

BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to...

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Detalles Bibliográficos
Autores principales: Cattermole, Giles N., Nzabandora, Jean-Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360740/
https://www.ncbi.nlm.nih.gov/pubmed/28324468
http://dx.doi.org/10.1186/s12245-017-0138-7
Descripción
Sumario:BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. He was resuscitated with fluids, intubated and ventilated, and treated with insulin and antibiotics. On day 3, an ascaris worm was passed via his nasogastric tube, and abdominal ultrasound revealed a heavy worm load. He was treated with albendazole and eventually made a full recovery. CONCLUSIONS: This is the first report of ascariasis as a potential cause of HHS, and we recommend that emergency practitioners consider early abdominal ultrasound in patients with hyperglycemic emergencies in areas with a high prevalence of ascariasis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12245-017-0138-7) contains supplementary material, which is available to authorized users.