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A Case of Expulsion of an Adult Ascaris Worm from the Anus of a 2-year-old Boy

2세 남아에서 충체 배출로 발견된 회충증 1예

  • Received : 2019.06.11
  • Accepted : 2019.09.25
  • Published : 2020.04.25

Abstract

Ascariasis is the most common helminthic infection in humans. However, its prevalence has been very low in Korea since the 1990s. Recently, there have been several case reports on intestinal obstruction or pancreaticobiliary disease due to infection with Ascaris lumbricoides in adults. However, cases of ascariasis in children have rarely been reported in Korea. We report a case of ascariasis in a 2-year-old boy who experienced expulsion of an adult ascaris worm from his anus. His mother found the worm in his diaper in the morning. His medical history was nonsignificant for any previous illnesses. There were no specific symptoms, and no abnormal findings were found on physical examination. The worm was pink, elongated, and cylindrical; it was 25 cm long and 5 mm wide. Unfertilized eggs of A. lumbricoides were detected in his stool specimen. He was treated with albendazole and remained asymptomatic at follow-up. As long as the number of immigrants from endemic areas and people returning from overseas trips, and import of agricultural products keep increasing, ascariasis can still occur in Korea. Therefore, it is necessary to raise awareness regarding ascariasis.

한국의 회충 감염률은 1970년대까지 높았으나 성공적인 기생충 관리로 매우 낮은 수준으로 감소하였다. 최근 회충 유행 지역으로부터의 인구 유입 및 해외여행 증가, 수입 농산물의 증가 등으로 인해 발생 가능성이 높아지는 가운데 성인에서 회충감염으로 장폐쇄나 췌담관 질환이 유발된 증례 보고들이 있었다. 저자들은 회충증을 의심할 만한 위험 요인이 없는 2세 남아의 기저귀에서 회충 성충이 발견된 증례를 경험하여 보고한다. 아침에 환아의 어머니가 기저귀를 갈다가 움직이는 충체를 발견하여 내원하였다. 특이 과거력 없이 평소 건강하던 환아로 이상 증상은 없었고 신체 진찰에서 특이 소견은 관찰되지 않았다. 충체는 길이 약 25 cm, 폭 5 mm의 선충으로 머리와 꼬리는 원추상을 보여 회충으로 추정하였고 대변 기생충란 검사에서 Ascaris lumbricoides의 불수정란이 확인되어 회충증으로 진단하였다. 구충제인 알벤다졸 400 mg을 1회 경구 투여 후 추적 관찰하였고 추가적인 회충 발견이나 증상 발생은 없었다. 전체적인 기생충 감염률이 감소하여 관심이 줄어드는 현실에서 회충 감염에 대한 인식을 높일 필요가 있겠다.

Keywords

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