Biliary ascariasis and severe bacterial outcomes: Report of three cases from a paediatric hospital in Brazil

Int J Infect Dis. 2020 Jun:95:115-117. doi: 10.1016/j.ijid.2020.03.045. Epub 2020 Mar 30.

Abstract

Introduction: Biliary ascariasis, although uncommon, can lead to infectious complications and severe outcomes. This study reported three patients with biliary ascariasis and who were admitted to a paediatric hospital in Salvador, Brazil.

Case reports: Case 1: A 1-year-old boy, with HIV, hospitalised with diarrhoea, fever, pain, and abdominal distension. He underwent an exploratory laparotomy, which showed peritonitis secondary to a perforation of the hepatic duct by ascaris. Case 2: A 3-year-old boy admitted with fever, abdominal pain and jaundice. Imaging examination was suggestive of ascaris in the intrahepatic biliary tract and a hepatic abscess. Case 3: A 7-year-old boy who was hospitalised with a history of abdominal colic, jaundice and fever, with a suggestive image of ascaris in the biliary tract and evolution to sepsis.

Discussion: Three cases of biliary ascariasis were reported with severe infectious complications involving peritonitis, hepatic abscess and sepsis.

Conclusion: In endemic regions, biliary ascariasis should be considered in cases with jaundice, abdominal pain and fever, due to its morbidity and risk of complications.

Keywords: Ascaris lumbricoides; Biliary ascariasis; Liver abscess; Sepsis.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Ascariasis / complications*
  • Ascariasis / diagnosis*
  • Ascariasis / diagnostic imaging
  • Bacterial Infections / parasitology*
  • Biliary Tract Diseases / complications
  • Biliary Tract Diseases / diagnosis*
  • Biliary Tract Diseases / diagnostic imaging
  • Biliary Tract Diseases / parasitology*
  • Brazil
  • Child
  • Child, Preschool
  • Coinfection*
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Liver Abscess / parasitology
  • Male
  • Peritonitis / parasitology
  • Sepsis / parasitology