Pneumonia Caused by the Ascaris Lumbricoides: A Case Report

Background Ascaridosis is widely spread in low-income countries because of poor hygienic conditions. This parasitosis is rare in Italy and the sporadic cases are reported in travelers from high-risk areas or infestation conveyed by contact with canine stool. Case History A 58-year-old man with chronic obstructive pulmonary disease (COPD) was admitted to the emergency Medicine Department for acute respiratory failure. He had taken cortisone and ceftriaxone at home for 10 days. Chest CT showed bilateral multiple pericentimetric pulmonary nodulations. Abdomen CT was normal. He complained of irregular alvus, so he performed pancolonscopy, which showed the presence of actively moving roundworms, so he was transferred to the Infectious Diseases Department. Three coproparassitological samples were positive for Ascaris lumbricoides. Blood exams were negative for peripheral eosinophilia, at bronchoalveolar lavage fluid mild increased eosinophils (6%). The patient was treated with albendazole 200 mg bid for three days with pulmonary and gastroenteric symptoms resolution. Discussion Ascaris can localize to the gastric and pulmonary tracts according to its life cycle, being able to cause eosinophilic pneumonia and gastrointestinal infestations. In this case, we hypothesized that the alveolar eosinophilia was not severe due to prolonged cortisone therapy. Appropriate treatment leads to a hasty resolution [1, 2].