Unexpected Colonoscopy Finding

Can you name that worm and give the classic treatment of choice?


"NEJM Case history for the video: A 60-year-old woman presented to the outpatient clinic with vague abdominal discomfort that had developed over the previous several weeks. There was no abdominal tenderness. Laboratory evaluation was notable for the white-cell count, which included 1.8% eosinophils. Colonoscopy demonstrated a worm, which moved. The worm had a smooth, cream-colored surface and was 20 cm in length. It was removed with an endoscopic snare and identified as Ascaris lumbricoides. The patient was given mebendazole; she did not pass any additional worms. Typically, complications from A. lumbricoides are associated with mechanical obstruction, such as migration of a worm into the biliary tree or the development of a high worm burden in the intestinal lumen. In this case, the abdominal discomfort resolved after the worm was removed. At a 2-month follow-up visit, the patient remained healthy."

Answer: The roundworm Ascaris lumbricoides which is treated with mebendazole.   Note: large numbers of these can cause intestinal obstruction!!!!


VideoSource: NEJMvideo

Photo: CDC Division of Parasitic Diseases


Category: Microbiology Mnemonics

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