An Unusual Case of Perforation Peritonitis: A Diagnostic DilemmaBacterial or Parasitic?

Abstract

Large intestinal perforation due to mixed parasitic and bacterial aetiology is a rare entity. We report the case of a 63 years old man, who underwent a therapeutic paracentesis for ascites, which revealed eggs of hookworm, along with E.coli. The patient was initially treated conservatively, until his vitals stabilised, following which, he was operated for the perforation. He improved subsequently and was discharged. To the best of our knowledge, this is the third case of an intestinal perforation attributed to a parasitic (hookworm) cause. Hence, this report highlights the datum, to consider parasites in the evaluation of perforation peritonitis, apart from trauma and common infections like Salmonella typhii and Mycobacterium tuberculosis relevant from the Indian perspective.

Keywords

• escherichia coli
• hookworm
• peritoneum