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yarab99
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03/12/08 - 04:08 PM

After receiving a heart transplant and immunosuppresive therapy, a 56 yr old man develops fever and lung infiltrates,brochalvealor lavage micro exam shows, a 1 mm worm,which is the root the infection was aquired???

A- ingestion of eggs in contaminated water

B-ingestion of infected feces

C-ingestion of larvae in infected meat

D-mosquito inoculation of larvae

E-skin penetration by larvae

jean robert
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03/12/08 - 04:11 PM

A?

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new_n_lost
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03/12/08 - 04:53 PM

B-ingestion of infected feces which should be >> ingestion of embryonated (infective) eggs in feces-contaminated soil >> Classical Case of only crazy worm Ascaris lumbricoides

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pr20
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03/12/08 - 05:40 PM

E-skin penetration by larvae??

Severe infection with hookworm in immunosuppressed people can cause pneumonitis.Ascaris can also be true but can it be so small in size(only 1 mm?).

I know its a wild guess rolling eyes

Tiff
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03/12/08 - 05:45 PM

Had it not been for the size of 1mm I probably would have thought Ascaris since it's most common. But this guy had immunosupressed therapy and strongyloids is what is most common in these patients and it is also this size. Therefore will have to go with choice E - skin penetration which is how Strongyloides is aquired.

new_n_lost
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03/12/08 - 05:48 PM

pr20 wrote:
E-skin penetration by larvae??

Severe infection with hookworm in immunosuppressed people can cause pneumonitis.Ascaris can also be true but can it be so small in size(only 1 mm?).

I know its a wild guess rolling eyes

You know you are right. Didnt pay attention to the 1mm part of the question. This could be very well of a Hookworm infestation as the size is more near to the size of Hookworm rather than Ascaris.

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pr20
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03/12/08 - 06:00 PM

You know you are right.

Really its only a guess.I was more worried about history of immunosuppression...if it was not given i would have never paid attention to the size.

yarab99
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03/12/08 - 06:15 PM

ooooooooook ,,,tiff nod

The answer is E- skin penitration with larvae

To answer we have to think :

1-who have a life cycle involing the lung ??

(ascaris,hookworms,strongyloids)

2-size 1 mm?

that takes out ascaris

3-immunosupressive therapy--latent infection?

MC is strongyloids...which infects by the larvea penitrating the skin

That was fun ..right???? grin

icarus
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04/07/08 - 06:26 PM

Thank you so much for this question, Enshallah YaRab tjeeb 99 ...

Kind regards,

IcarusMD

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yarab99
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04/07/08 - 10:30 PM

#10

Ameeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeen

bactitech
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04/26/08 - 08:03 PM

#11

Size IS everything - in parasitology nod

This is a huge clue. Ascaris are much larger than 1 mm.

http://en.wikipedia.org/wiki/Strongyloides - they list Strongyloides as being 2.5 mm.

I have seen them in sputum cultures where they wiggle around and leave tracks in the bacteria on the plate. It is pretty gross. I only saw this once. Strongyloides infection is pretty serious.

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