TWiP 179: Verminous visitors

January 11, 2020
Ascaris skirt

The TWiP DVD solve the case of the Child Who Passed Worms, and discuss a non-human primate model for severe malarial anemia.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Download TWiP #179 (63 MB .mp3, 103 minutes)
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Case Study for TWiP 179

From Uganda, eastern up in mountains, rainy season. 6 yo girl brought in by mother on Monday, reporting several days of feeling poorly, headache, fever, muscle aches. Negative malaria smear on Monday. Wednesday returns, feeling worse, fever higher, headache worse. Lungs clear, belly (pain on left side) has large spleen. Living in good conditions, well dressed, dirt floor house, concrete walls. Toilet is hole in back. Same dietary habits, high in carbs. No mosquito netting. Water from stream. No siblings. HIV negative.

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Music by Ronald Jenkees

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2 comments on “TWiP 179: Verminous visitors

  1. Rich Bradley Jan 13, 2020

    Dear TWIP hosts,
    Having missed the cut-off for the last episode I am getting my guess in on TWIP 179 immediate I heard the episode.
    Headache, fever, and muscle aches are all classic malaria signs, as is enlarged spleen. The cdc website (see below) notes a number of malaria species are endemic and recommends atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine. Young children are also most at risk as they haven’t built up an immune defence and her mother’s antibodies would have run out, so it is probable she has had chronic malaria. The reason for the initial negative smear could be a false negative or the body has cleared the parasite but the impact of chronic exposure is still being felt. Other parasites such as VL may caused some of the symptoms but are less likely (when in Africa hoofbeats suggests zebras not horses…)