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Pediatría (Asunción)

On-line version ISSN 1683-9803


GARAY, Nancy et al. Ascaris Lumbricoides: cardiac complications and emergency surgical resolution. Pediatr. (Asunción) [online]. 2019, vol.46, n.2, pp.118-124. ISSN 1683-9803.


Geohelminthiasis intestinal parasitosis is one of the neglected Infectious Diseases (WHO) that affects vulnerable populations. Predisposing factors are: poor housing conditions, low economic income and poor educational level. Of the helminths, Ascaris lumbricoides is the largest intestinal nematode in humans - it reaches up to 40 centimeters. The clinical presentation depends on the degree of infestation, which varies from anemia, asthenia, weight loss to internal invasion of organs such as liver, lungs, brain and the heart in severe cases.

Case Report:

A 16-month-old girl with a history of prolonged fever and spontaneous expulsion of parasites through a natural orifice, arrived at the emergency department with symptoms of cardiorespiratory shock. Echocardiography showed foreign bodies in the form of tapes and with spontaneous movements, compatible with cardiac parasites (2 in the atrium and right ventricle and 1 riding the pulmonary arteries); at echocardiographic follow-up, multiple thrombi were found along the parasite located in the right atrium and, given the severity of the condition, emergency surgical removal was performed 4 adult parasites were removed, with clots adhered to one of them.


The parasitological and pathological study concluded that the parasites were adult Ascaris lumbricoides females. The patient was discharged on the 8th post-operative day in good condition. Although this case was successful, the cardiac complications and serious systemic infections have a high morbidity and mortality, which can be avoided with deworming programs and reduction of parasite load through improvements in environmental sanitation and health education. To our knowledge, this is the first reported case of Ascaris Lumbricoides adult form extraction from the human heart in the world.

Keywords : Ascaris lumbricoides; heart; thrombi; cardiac surgery.

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