Disseminated Armillifer armillatus Infestation: A Rare Cause of Acute Abdomen

We report a case of an 80-year-old symptomatic female with severe visceral Armillifer armillatus infestation who presented with complaints of progressively worsening colicky abdominal pain with associated constipation and mild abdominal distension. Imaging workup demonstrated unique radiological features of the parasite including multiple curvilinear opacities, measuring approximately 3 to 6 mm in length, scattered in the lung fields, abdomen, pelvis, and inguinal region. Histologic examination of inguinal biopsies revealed enlarged lymph nodes containing several parasitic pseudocysts. She was managed conservatively and received antihelmintics, with subsequent uneventful recovery. This case emphasizes the importance of meticulous differential diagnoses formulation. In the right clinical scenario, pentastomiasis should be considered in the differential diagnoses of patients with imaging evidence of multiple organ lesions, as a high index of suspicion is needed for the diagnosis of this entity and will help to avoid unnecessary invasive management.