NEJM: Aphids in the stomach - case report

The patient, a 20-year-old man, was treated for abdominal pain, diarrhoea and vomiting for one day.
he was healthy and had no relevant medical history.
heart rate 96 times per minute and blood pressure is 96/60mmHg.
tested, the abdomen is soft and pain-free.
laboratory examination found that hemoglobin levels were 19.5 μg/dl (reference range 12 to 15), white blood cell count was 20800/m3 (reference range 4000 to 11000), neophils were 72.7%, and eosinophil count was 25/m3 (reference range 20 to 500).
an immediate ultrasound of the lower cavity veins to assess the patient's intravascular fluid status.
during the examination, a titular echo structure with curly motion was seen inside the stomach cavity (as shown in Figure A).
the parasites and eggs in the feces, found the eggs (shown in Figure B) and diagnosed them with aphid disease.
addition to receiving intravenous fluids, the patient was also given a single dose of 400 mg of abenzene, which was discharged after 1 day in hospital.
follow-up in the clinic two weeks after he was discharged, reported feeling well and noted that he had excreted aphids from the stool.
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