| Parasitic Diseases: | Case 1 | Case 2 | Case 3 | Case 4 |
Caution for health status in New Immigrants from Rural China
Case 4 (by Yeung Chap-Yung)
| Patient: 10 years old girl |
|
| Source: Hong Kong, 1965 |
|
| Presenting features: | |
| Acute severe Right upper quadrant pain with vomiting fever and increasing obstructive jaundice x one day. | |
| Similar but less severe episode before, treated well. | |
| Liver and gall bladder enlarged and tender, Spleen 2 cm. |
|
| Relevant Investigations and Progress: | |
| Blood culture positive for E. coli. | |
| Exploratory laparotomy showed biliary mud in biliary tract + freshly dead
ascaris in common bile duct and gall bladder. |
|
| Diagnosis: | |
| Recurrent pyogenic cholangitis - from heavy ascaris infestation. E. Coli septicemia |
|
| Other cases encountered: | |
| Abdominal pain from intermittent intestinal obstruction due to bolus of
ascaris worm intertwining together. |
|
| Lessons: | |
| 1) | Multiple worm infestations are common from developing communities ( HK in the early 60s ) and rural China even now. 60% of rural population in China are infested with Ascaris even in recent few years. |
| 2) | Caution needed when caring for Chinese children who recently emigrate from Rural China. |