TWiP 147: The savvy physician tests the tissue

The three amigos of parasitology solve the case of the New York Lawyer With A Foot Ulcer, and discuss a survey of rodents for the raccoon roundworm in California. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Become a patron of TWiP. Links for this episode: Monthly case studies (CDC) The Parasite on the Playground (NYTimes) Introduced rats and raccoon roundworm (J Parasitol) Parasite Hero: Theodor Bilharz Letters read on TWiP 147 Case Study for TWiP 147 Three year old boy, in tropical S. America, brought in by mother, says has been sick about a month. Previously healthy, 4 healty siblings, vaccines up to date, now has abdominal pain. Belly pain increases throughout day, poor appetite, constipated, has goat stools, pellets. Has had fever, seems swollen, face pale, urine dark, belly distended. Occasionally coughs. Living conditions: home has dirt floor where he spends most of day. On exam is febrile, doesn’t look well, no teeth, sleepy, not responsive, distended belly, pale, weight 13 kg. Diffuse scaly skin inflammation around perianal area, breakdown of skin around mouth. HIV, HTLV1 negative. Dogs, chickens, goats around, they come in house. Stool O&P; sent out, contained something that gave diagnosis. Send your case diagnosis, questions and comments to [email protected] Music by Ronald Jenkees