Shahid Manzur, Irfan Ul Haq, Shahfqat Yazdani, Abid Mehmood.
Para-Aortic and mesenteric lymphadenopathy associated with Ankylostoma Duodenale infestation
Pak Armed Forces Med J Jun 2003;53(1):107-10.
Bahawal Victoria Hospital, Bahawalpur
A 25 years male, reported with acute upper abdominal pain. Patient gave history of upper abdominal pain, ranging from vague discomfort to severe griping pain, for last six months. There was also history of loss of appetite but pain was having no relation with duration or type of meal intake. Patient lost about 3Kg of his weight in 6 months and developed generalized weakness and easy fatigability. On examination he was anemic. There was mild tenderness all over the abdomen. No mass was palpable in abdomen. Bowel sounds were prominent. Rest of the systemic examination revealed no abnormality. Abdominal Ultrasound revealed enlarged para-aortic lymph nodes. Blood picture showed marked eosinophilia with raised ESR. Due to repeated pains, Exploratory Laparotomy was carried out, which did not reveal anything other than lymphadenopathy. Provisonal diagnosis of Lymphoma was made. Histopathology of lymph node showed reactive hyperplasia. Considering it as improper report, immunohistochemical studies for lymphoma were done, which were negative. Despite negative biopsy reports, consultant physician put the patient on ATT due to GI symptoms. Patient took ATT for 3 months without any improvement. He was also advised radiotherapy by some GP. After three years, he was again examined and had similar findings. Case was reviewed and Stool examination was advised, which showed numerous ova of Ankylostoma duodenale. Patient was given treatment for hookworm infestation along with iron. His symptoms improved. His repeated stool examination and ultrasound were normal after 1 month of therapy.
Category: Case Reports
Keywords: Lymphadenopathy. Ankylostoma Duodenale. Hookworm. Anemia.
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