CASE 49
A 3-year-old girl was brought to the emergency department of a general hospital following a 3-week history of nausea, poor appetite, and abdominal pain. She had not had any bowel movements for the last 2 days.
The patient was of Mexican origin and had recently moved from Mexico with her mother to South Texas.
LABORATORY STUDIES
Diagnostic Work-Up
Table 49-1 lists the likely causes of illness (differential diagnosis). Intestinal worm infection was considered based on clinical features and x-ray evidence. Diagnosis is confirmed by identification of ova and parasites by microscopy of trichrome- or iodine-stained concentrated fecal specimens.
TABLE 49-1 Differential Diagnosis and Rationale for Inclusion (consideration)
Rationale: Abdominal symptoms with eosinophilia have a relatively limited differential, mainly parasitic infection. The various causes can be reliably determined only through stool examination for ova and parasites. Noninfectious causes may also cause similar symptoms but will not demonstrate eosinophilia.
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