Pneumoascariasis: An Unusual Pulmonary Manifestation of Ascaris lumbricoides Infection

Background Pneumoascariasis, a pulmonary manifestation of Ascaris lumbricoides infection, is infrequently recognized in clinical practice despite the global prevalence of ascariasis. The symptoms often mimic community-acquired pneumonia or bronchial asthma, leading to diagnostic challenges. We present an unusual case of pneumoascariasis in an elderly female who presented with respiratory symptoms and was found to have worm migration through multiple body sites. Case Presentation A 70-year-old female with no known comorbidities presented with fever, productive cough, and dysphagia for 3 days. Physical examination revealed tachycardia, tachypnea, hypoxia and pallor. Respiratory examination showed bilateral basal crepitations. On day 2 of hospitalization, creamy-colored worms were observed in the patient’s stool, nasal cavity, and oral cavity. Stool examination confirmed Ascaris lumbricoides infection, and radiological findings revealed bilateral lower zone pneumonitis. The patient was diagnosed with pneumoascariasis (post-lung phase) and was successfully treated with anti-helminthic therapy, antibiotics, and corticosteroids. Conclusion This case highlights the importance of considering parasitic infections in the differential diagnosis of respiratory symptoms, particularly in endemic regions. Pulmonary symptoms may be the predominant manifestation of ascariasis, necessitating a high index of clinical suspicion for timely diagnosis and appropriate management.