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Severe acute respiratory distress syndrome in a woman infected with Ascaris lumbricoides Cover

Severe acute respiratory distress syndrome in a woman infected with Ascaris lumbricoides

The Journal of Critical Care Medicine
Volume 11 (2025): Issue 4 (October 2025)
By: Alexandra Elena Lazar and  Mihai Claudiu Pui  
Open Access
|Oct 2025

Figures & Tables

Fig. 1.

A. Thoracic CT angiography, axial section, acquired with intravenous contrast, pulmonary window. B. Thoracic CT angiography, coronal section, acquired with intravenous contrast, pulmonary window.
A. Thoracic CT angiography, axial section, acquired with intravenous contrast, pulmonary window. B. Thoracic CT angiography, coronal section, acquired with intravenous contrast, pulmonary window.

Fig. 2.

Ascaris lumbricoides extracted with the nasogastric tube
Ascaris lumbricoides extracted with the nasogastric tube

Fig. 3.

Anteroposterior chest X-ray performed on day 12 of ICU stay (day 12 of ARDS evolution) and day 4 after extubation, showing significant improvement in lung aeration.
Anteroposterior chest X-ray performed on day 12 of ICU stay (day 12 of ARDS evolution) and day 4 after extubation, showing significant improvement in lung aeration.

Chronological Patient Monitoring Report – ICU

DayUrine (mL/day)CVP (cmH2O)CulturesGCSRASSATBxSteroidsSedation / Neuromuscular Blockade
180015

  • Blood culture pending; tracheal aspirate collected.

  • Respiratory panel negative – (COVID, Flu, Influenza)

-−3

  • Vancomycin

  • Meropenem

  • Moxifloxacin

  • (Avelox®, Bayer, Germania)

MethylprednisoloneFentanyl + Midazolam
2170017Cultures: negative-−2Vancomycin + Meropenem + MoxifloxacinMethylprednisoloneFentanyl + Midazolam, Rocuronium bromide
3240015Ascaris Lumbricoides identified-−3Vancomycin + Meropenem + Moxifloxacin + AlbendazoleMethylprednisoloneFentanyl + Midazolam, Rocuronium bromide
4300012--−2Vancomycin + Meropenem + Moxifloxacin + AlbendazoleMethylprednisoloneFentanyl + Midazolam, Rocuronium bromide
528009--−3Vancomycin + Meropenem + Moxifloxacin + AlbendazoleMethylprednisoloneFentanyl + Midazolam, Rocuronium bromide
6430013–-−3Vancomycin + Meropenem + Moxifloxacin + AlbendazoleMethylprednisolone Tapered doseFentanyl + Midazolam, Rocuronium bromide
7240016–7−3 after sedation restartVancomycin + Meropenem (Moxifloxaci stopped)Methylprednisolone Tapered doseSedation interrupted for neurological evaluation; severe agitation & tachypnea; sedation restarted: Fentanyl + Midazolam
847009–150Vancomycin + Meropenem Sedation stopped (patient extubated)
936008–150Vancomycin + Meropenem––
1038008–150Ceftazidime (Fortum®, GSK, UK)––
1130009–150Ceftazidime––
1235009–150Ceftazidime–discharged from ICU

Paraclinical data

DAY123456789101112Normal valuesUnits
pH7.317.457.507.437.437.397.667.537.557.637.37-7.35 7.45-
PaO2687272135143145172122140154125-83 – 108mmHg
PaCO272514651506429.042332643-35 – 45mmHg
Lactate0.821.21.41.61.51.51,42.21.31.3-<1.3mmol/l
COHb0.51.22.111.21.91.411.40.81.2-0.5–1.5%
P/F687071193204242246203350385396-> 300mmHg
A-aDO2-5795863002942032912531049985--mmHg
RI-8.38,42.22.11.41.72.10.70.60.4-< 0.4-
HCO337.423540.233.933.238.732.735.128.927.424-22 – 28mmol/L
White Blood Cells26.7910.52-7.5-5.75-7.35-6.9-6.073.6 – 1010^3/µL
Neutrophils18.529.36-5.49-4.16-5.77-5.07-3.381.4 – 6.510^3/µL
Eosinophils0.030.010.040.010.000.010.010.000.020.270.04--109/L
C-reactive protein63.36204.4-56.8-19.1-16.3-16.3--<5mg/L
Creatinine0.590.6-0.48-0.4-0.38-0.3-0.60.57 – 1.11mg/dL
DOI: https://doi.org/10.2478/jccm-2025-0039 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
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Language: English
Page range: 435 - 441
Submitted on: Mar 15, 2025
Accepted on: Aug 25, 2025
Published on: Oct 31, 2025
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
ARDS,
Ascaris lumbricoides,
parasitic infections,
acute respiratory failure,
helminth infections
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Internal medicine, other,
Surgery,
Surgery, other,
Anaesthesiology,
Emergency medicine and intensive-care medicine

© 2025 Alexandra Elena Lazar, Mihai Claudiu Pui, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.

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