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Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation

With increasing travel and immunosuppression, parasitic lung and pleural diseases are increasingly been reported. The diagnosis in certain cases is very challenging because of nonspecific clinical and radiological features. We hereby present a case of a 60-year-old immunocompetent female complaining...

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Autores principales: Mehta, Vibha, Loomba, Poonam S., Mishra, Bibhabati, Sakhuja, Puja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648293/
https://www.ncbi.nlm.nih.gov/pubmed/36387681
http://dx.doi.org/10.4103/jfmpc.jfmpc_1482_21
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author Mehta, Vibha
Loomba, Poonam S.
Mishra, Bibhabati
Sakhuja, Puja
author_facet Mehta, Vibha
Loomba, Poonam S.
Mishra, Bibhabati
Sakhuja, Puja
author_sort Mehta, Vibha
collection PubMed
description With increasing travel and immunosuppression, parasitic lung and pleural diseases are increasingly been reported. The diagnosis in certain cases is very challenging because of nonspecific clinical and radiological features. We hereby present a case of a 60-year-old immunocompetent female complaining of difficulty in breathing for 4–5 days for which sputum sample along with the coughed-up fragment of the parasite under investigation was sent to the laboratory. All the blood parameters along with blood and sputum culture were within normal limits. Direct microscopy for sputum and multiple fecal samples did not yield any significant information. Chest X-ray was normal, whereas contrast-enhanced computed tomography scan changes were suggestive of fibrotic changes and mucoid impaction. The histopathological examination showed thick mucus content and no evidence of a parasitic infestation, worm, larva, or ova. So the differential diagnosis of the right lower lobe obstruction probably due to mucus plug was made, and the patient was referred to a pulmonologist for further follow-up. This case highlights the importance of common respiratory disorders characterized by mucus plugs and that some may mimic parasitic segments. Specific clinical, radiological, and pathologic features, microscopic examination, or serological testing can help to narrow the differential diagnosis of infective or noninfective causes and help the patients in early and accurate diagnosis and treatment and save them from unnecessary expensive and invasive investigations.
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spelling pubmed-96482932022-11-15 Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation Mehta, Vibha Loomba, Poonam S. Mishra, Bibhabati Sakhuja, Puja J Family Med Prim Care Case Report With increasing travel and immunosuppression, parasitic lung and pleural diseases are increasingly been reported. The diagnosis in certain cases is very challenging because of nonspecific clinical and radiological features. We hereby present a case of a 60-year-old immunocompetent female complaining of difficulty in breathing for 4–5 days for which sputum sample along with the coughed-up fragment of the parasite under investigation was sent to the laboratory. All the blood parameters along with blood and sputum culture were within normal limits. Direct microscopy for sputum and multiple fecal samples did not yield any significant information. Chest X-ray was normal, whereas contrast-enhanced computed tomography scan changes were suggestive of fibrotic changes and mucoid impaction. The histopathological examination showed thick mucus content and no evidence of a parasitic infestation, worm, larva, or ova. So the differential diagnosis of the right lower lobe obstruction probably due to mucus plug was made, and the patient was referred to a pulmonologist for further follow-up. This case highlights the importance of common respiratory disorders characterized by mucus plugs and that some may mimic parasitic segments. Specific clinical, radiological, and pathologic features, microscopic examination, or serological testing can help to narrow the differential diagnosis of infective or noninfective causes and help the patients in early and accurate diagnosis and treatment and save them from unnecessary expensive and invasive investigations. Wolters Kluwer - Medknow 2022-07 2022-07-22 /pmc/articles/PMC9648293/ /pubmed/36387681 http://dx.doi.org/10.4103/jfmpc.jfmpc_1482_21 Text en Copyright: © 2022 Journal of Family Medicine and Primary Care https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Mehta, Vibha
Loomba, Poonam S.
Mishra, Bibhabati
Sakhuja, Puja
Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation
title Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation
title_full Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation
title_fullStr Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation
title_full_unstemmed Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation
title_short Bronchial mucus plug mimicking fragmented Ascaris worm: An ambiguous case presentation
title_sort bronchial mucus plug mimicking fragmented ascaris worm: an ambiguous case presentation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648293/
https://www.ncbi.nlm.nih.gov/pubmed/36387681
http://dx.doi.org/10.4103/jfmpc.jfmpc_1482_21
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