Ascariasis pneumonitis: a potentially fatal complication in smoke inhalation injury

J. P. Heggers, M. J. Muller, E. Elwood, David Herndon

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Ascaris pneumonitis in areas of endemic infestation is considered a benign condition. Smoke inhalation with any burn injury can be potentially fatal. A heavy infestation of Ascaris could further exacerbate the smoke-induced lung injury. After ingested eggs hatch in the small intestine, the larvae penetrate the mucosa and invade the blood stream and are then carried to the lungs. The larvae break out into the aveolar spaces as they are too large to cross the capillary bed and are carried up the bronchial tree and eventually swallowed. This study describes three cases of Ascaris infection in thermally injured children. While the burns were < 30 per cent total body surface area, two patients who were injured in the same fire had a further complication of smoke inhalation which necessitated sophisticated therapy in order to promote survival. All patients were treated initially with Vermox. The one patient without smoke inhalation did not develop ascariasis pneumonitis even with positive stool samples and was discharged with no complications, whereas the two with smoke inhalation developed severe pneumonitis. One patient was placed on ECMO and did not receive a full course of the Vermox treatment. This patient died after several weeks of ECMO treatment. The third patient received a full course of Vermox, slowly recovered, and went home. Supportive therapy only is recommended during the lung migration phase of the Ascaris lifecycle. We feel that continuation of chemotherapy (Vermox) would have been beneficial in the fatal case based on the survival of the second patient. Ascaris-induced lung injury superimposed upon severe smoke-induced lung injury may have had an additive effect that precipitated severe, unrecoverable respiratory failure.

Original languageEnglish (US)
Pages (from-to)149-151
Number of pages3
JournalBurns
Volume21
Issue number2
DOIs
StatePublished - 1995

Fingerprint

Smoke Inhalation Injury
Ascariasis
Ascaris
Pneumonia
Smoke
Mebendazole
Inhalation
Lung Injury
Larva
Lung
Extracorporeal Membrane Oxygenation
Survival
Body Surface Area
Burns
Respiratory Insufficiency
Eggs
Small Intestine
Mucous Membrane
Therapeutics
Drug Therapy

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Emergency Medicine
  • Surgery

Cite this

Ascariasis pneumonitis : a potentially fatal complication in smoke inhalation injury. / Heggers, J. P.; Muller, M. J.; Elwood, E.; Herndon, David.

In: Burns, Vol. 21, No. 2, 1995, p. 149-151.

Research output: Contribution to journalArticle

Heggers, JP, Muller, MJ, Elwood, E & Herndon, D 1995, 'Ascariasis pneumonitis: a potentially fatal complication in smoke inhalation injury', Burns, vol. 21, no. 2, pp. 149-151. https://doi.org/10.1016/0305-4179(95)92143-Z
Heggers, J. P. ; Muller, M. J. ; Elwood, E. ; Herndon, David. / Ascariasis pneumonitis : a potentially fatal complication in smoke inhalation injury. In: Burns. 1995 ; Vol. 21, No. 2. pp. 149-151.
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