Friday, August 14, 2009
Dog tapeworms in a baby (human)
My client was a woman with two spaniels and a baby in her arms. My patients were the two dogs and the baby although I had no idea the baby was included in that office visit. As I placed one of the dogs on the examination table the woman handed me a veil with about 50 tapeworm segments in a solution. I recognized the situation, I thought, immediately and looked under the dog on the tables tail to point out dried tapeworm segments clinging to the hair.There were perhaps a hundred of them. I told the woman what the problem was and our policy of dispensing medication to be used at home. That was about a year after I had started my veterinary practice so I was not favorably impressed when she asked, "How can you be sure they are tapeworms?" Rather than telling her what I thought of her questioning me I asked her to accompany me to my laboratory where I took a segment from the veil she had presented me with and crushed it out on a microscope slide and asked her to observe the eggs under the scope. I opened a text book with pictures of the worm eggs in the book. Then she dropped a bomb. "Those segments I gave you are from one diaper change of my baby." Of course I told her I would never have looked at her specimens had I known they were from her baby. an hour passed and I was called to the phone by the baby's doctor who lambasted me with all the common cuss words and a few more and finished by saying he would have my license and he hung up before I could say a word. That was not the end of the caper. Ten minutes passed and the client wanted to speak to me. It seems she was standing in front of the doctor's desk when he used such vile language and she said obviously was right and what she do about finding another pediatrician for her child. I knew one at Yale New Haven Hospital and that is where she took her child. The hospital pediatrician could not kill all the worms and asked that the baby be nourished for a while and returned for further treatment.The end? Not quite. A year passed and the client returned with her dogs and the baby. I asked her about the tapeworms in her baby and she informed me that they had a leak in a pipe behind the oil stove and she had placed a coffee can to catch the oil. The baby crawled behind the stove and drank some oil and later expelled all her worms. Another pediatrician friend was surprised as he said, many children have died from drinking such oil. It is absorbed in the intestine into the blood stream where it passes with the normal circulation through the lungs causing mechanical pneumonia. Incidentally one treatment for each dog given at home that destroyed the dogs' worms and with flea control, since fleas are the intermediate host of that tapeworm that was the happy end of this case.