I am suffering from serious worm infestation for more than two years. Please help.

Question

Hello doctor,

I am sick for more than two years. I have ear infections, sinus mastoiditis, folliculitis. I have a complaint of worms crawling, fluid at the back of skull, and scarring in the lungs. One and a half years ago, I complained something worms crawling in my butt but the test is negative. Six months back, I had rashes on my chest. Recently, I woke up to something in my throat and I stuck my hand in and pulled out a 15 inch worm. No doctors my area to treat me. I am on Albendazole for now.

Answer 1

Hello,

Welcome to icliniq.com.

Well, overall history and evidence of long crawling worms seems to be ascariasis. The worm causing ascariasis is ascaria lumbricoides. The other possibility given a cyst and which was drained can be hydatid cyst, to which Albendazole is similarly indicated but the duration of the treatment with Albendazole for hydatid cyst is two months.

The treatment has to be taken as three weeks on, one week off, three weeks on, and lastly one week off, to a complete total of two months. For ascariasis however, Albendazole 400 mg (antihelmintic) only one dose is a reasonable and effective treatment.

But the worm can still persist in the body in its ova form and has to be evaluated after three months of last treatment, and retreated with the same if adult worm or ova are identified. Since you have an extensive disease which is often refractory and do require surgery at certain stages for debridement of the necrotic cyst tissues whenever they cause pain or pus formation or fever. Since we are no sure which worm it is ascariasis (which seems likely) and/or hydatid disease worm (which require a longer course of Albendazole), the treatment duration is in question.

If you could share with me all your previous reports and upload the CT (computerized tomography) scan that you had and notes of cyst drainage, I may be in a better position to differentiate between two infections and can guide you the right duration of Albendazole. You can reach me out via chat, phone or video consultation.