Strange evolution in a child with plurimicrobial infection: case presentation

Parasitic infections are still prevalent in many areas, especially in developing countries. Ascariasis is the second most common parasitic infection worldwide. They can mimic different diseases and can remain undiagnosed or misdiagnosed. (1) Extraintestinal manifestation of ascariasis is pulmonary ascariasis which manifests as eosinophils accumulation in the lung, known as Löffler syndrome.
The patient was a 3 years old boy admitted to our pediatric department. He experienced fever, productive cough, dyspnea and loss of appetite two days prior to the admittance.
Clinical examination at the admission pointed out average general condition, cyanosis, generalized pallor, respiratory distress, subcostal and intercostals retractions, prolonged expiration and bilateral crackling rales, signs of mild dehydration.
Initial findings: high immunoglobulin E level, negative oropharyngeal cultures, nasal cultures- Staphilococcus aureus (carrier). X-ray examination was consistent with interstitial pneumonia and pneumonic infiltrations.
In evolution, the patient became unable to walk or eat, was extremely torpid, asthenic and had a decreased urine output. During the hospitalization period the patient presented watery stools with massive elimination of Ascaris lumbricoides. Coprological examination revealed the presence of Giardia lamblia cysts, Rotavirus and, Candida. Antiparasitic treatment along with antifungal treatment was initiated.